Issuu

Fall 2023 | Volume 73 | Number 3

NJ PSYCHOLOGIST The Professional Journal of the New Jersey Psychological Association

In this issue: President's Message A Review of the Emotional and Academic Impact of COVID-19 on College Students (1 CE) Harm Reduction is Health Equity: Navigating and Improving Accessible Treatment for Individuals With Eating Disorders and Substance Use Disorder in a Post-Pandemic World Training “Competent” Clinicians: How to Ensure Psychologists are Meeting the Ethical Guideline of Practicing within the Boundaries of Competence Do You Have Headphones For Your Tablet? Clinical Considerations For Providing Evidence-Based Trauma Focused Teletherapy to Children and Their Families Telemental Health for Individuals Incarcerated: Connecting Clients in Carceral Settings ...and more!

Executive Board President: Briana Cox, PsyD President-Elect: Marc Gironda, PsyD Past-President: Peter DeNigris, PsyD Secretary: Alexandra Miller Clark, PsyD Acting Treasurer: Daniel Lee, PsyD Parliamentarian: Bonnie Markham, PhD Members-At-Large: Elio Arrechea, PhD Daniel DaSilva, PhD Jane Simon, PhD Alex Gil, PsyD Lauren Gerardi, PhD Deirdre Waters, PsyD APA Council Representative: Rhonda Allen, PhD Special Representatives: ECP Chair: TBD NJPAGS Chair: Jaclyn Hammond Affiliate Caucus Chair: Phyllis Bolling, PhD CODI Co-Chairs: Phyllis Bolling, PhD & TBD Executive Director: Sara Tedrick Parikh, PhD Director of Professional Affairs: Susan C. McGroarty, PhD Affiliate Organization Representatives: Essex/Union County Association of Psychologists: William MacLaney, PsyD Northeast Counties Association of Psychologists: Alison Winston, PhD Mercer County Psychological Association: Loraine Washton, PhD Middlesex County Association of Psychologists: TBD Monmouth/Ocean County Psychological Association: TBD Morris County Psychological Association: Sarah Dougherty, PsyD Somerset/Hunterdon/Warren County Psychological Association: TBD South Jersey Psychological Association: Ange Puig, PhD Editorial Board: Editor: Aaron Gubi, PhD Homestudy CE Article Editor: Dennis Finger, EdD Editorial Board Members: Anthony Tasso, PhD Nathan McClelland, PhD Staff Liaison: Christine Gurriere

We're here to help! Central Office: 8:30 am – 4:00 pm Phone: 973-243-9800 STAFF CONTACT INFORMATION Executive Director: Sara Tedrick Parikh, PhD njpaed@psychologynj.org Director of Operations: Amy Chapman, PhD njpadoo@psychologynj.org Communications: Christine Gurriere njpacg@psychologynj.org Continuing Education: Kaleigh White njpakw@psychologynj.org Director of Professional Affairs: Susan McGroarty, PhD Consultation Request (login required)

Contents 2

Editor’s Note

Executive Director Update

President’s Message

A Review of the Emotional and Academic Impact of COVID-19 on College Students (1 CE)

Harm Reduction is Health Equity: Navigating and Improving Accessible Treatment for Individuals With Eating Disorders and Substance Use Disorder in a Post-Pandemic World

Member News

Training “Competent” Clinicians: How to Ensure Psychologists are Meeting the Ethical Guideline of Practicing within the Boundaries of Competence

Do You Have Headphones For Your Tablet? Clinical Considerations For Providing Evidence-Based Trauma Focused Teletherapy to Children and Their Families

NJPA Foundation Community Service Program Grants

Welcome New Members!

Telemental Health for Individuals Incarcerated: Connecting Clients in Carceral Settings

Thirty-Five Years as a Forensic Psychologist: A Retrospective

On Planning Your Retirement: Some Personal Suggestions

APA Council of Representatives Report

COLA Legislative Report

NJ Psychologist

Fall 2023

Editor’s Note

Nesrin Hisli Sahin, Dr. Nicole A. Perez, and Carly T. Pasquale, present a comprehensive analysis regarding the social, emotional, and academic impact of COVID-19 on college students. This data-driven exploration is essential reading for educators, faculty members, trainers, and psychologists alike. Substance misuse has notably increased as a significant public health concern over the past decade. This challenge has gained prominence as it directly and indirectly impacts the lives of many individuals, and the associated costs are becoming increasingly evident. In this context, Alexis Libert, a doctoral student, and Dr. Jonathan Sepulveda address the crucial issue of harm reduction and substance-related challenges in a postCOVID world. Their article illuminates the distinct challenges and therapeutic opportunities that have arisen in the aftermath of the pandemic.

By Aaron Gubi, PhD NJ Psychologist Editor

Two complementary articles similarly examine the evolving changes in treating clients presenting with some of the most pressing and complex concerns. Turning our attention first to the compassionate work of Drs. Kristine Hodoshon and Elizabeth McIntyre from the CARES Institute at Rowan Medicine, we explore the intricate clinical considerations and essential guidance for psychologists working with traumatized children and families. Their lessons learned in reaching and treating this challenging population are invaluable. Similarly, we examine current and evolving practices within correctional facilities, as written by doctoral student Blanca Garcia, joined by Elisha Beinart, LMSW, and Dr. David Brandwein. This article illuminates the unmet treatment needs and possibilities to improve care for direly underserved clients within carceral settings.

As I sit down to write this introduction for the latest issue of our association journal, I am filled with mixed emotions. It is hard to believe that my three-year journey as the journal's editor is coming to an end. This experience has been one I deeply cherish, but as I bid farewell to this role, I cannot help but feel an immense sense of enthusiasm and anticipation for what lies ahead. I assumed this role in April 2020, right at the beginning of the pandemic. Over the past three years, as all our lives have been intricately impacted, I have had the privilege of overseeing the publication of numerous thought-provoking articles. These articles have documented the changes in our field and showcased the resilience of our local colleagues in sharing new and evolving visions of our profession as psychologists. It has been an incredible journey, and I am grateful for the trust that you, my fellow psychologists, have placed in me.

Lastly, we delve into an engrossing interview with Matthew Johnson, a veteran of forensic psychology with an illustrious 35year career. Through his reflections, we gain insights into the evolution of the forensic field, marked by notable achievements and challenges. Similarly, Dr. Kornhaber invites us to peer into a long and captivating career as a psychologist, offering invaluable insights into the often-overlooked aspect of retirement planning. Both articles are highly relevant for many of us and our colleagues as we approach or reach this pivotal point in our lives.

However, all good things must come to an end, and it is with great pleasure that I announce my successor, Dr. Nouriman Gharary. She will take the reins as the new editor starting with the winter issue. Dr. Gharary brings a wealth of experience and expertise to this role, and I am confident that she will continue to uphold the high standards of excellence that our journal strives for. Dr. Gharary is a counseling psychologist, an associate professor of psychology, and the director of clinical training for the PsyD program in counseling psychology at Felician University. Her dedication to the field and commitment to fostering meaningful discourse within the realm of psychology makes her the ideal choice to lead our journal into the future.

In closing, I wish to extend my deepest gratitude to our esteemed readers, authors, reviewers, and the dedicated editorial team. Your contributions have made my tenure as editor a wonderful experience. I'd like to extend special thanks to Dr. Dennis Finger, an editorial board member and our continuing education editor, for providing invaluable support to me, the editorial board, and numerous colleagues in completing their featured homestudy articles and obtaining essential continuing education credits. I also wish to acknowledge Christine Gurriere for her tireless efforts in layout and production, which have played a pivotal role in bringing our journal to publication. I eagerly anticipate the continued growth of this publication under the capable leadership of Dr. Gharary. I remain a dedicated supporter and contributor to our association journal, looking forward to the future insights and contributions that will further enrich our local colleagues and our profession as a whole.

As we embark on this new chapter under Dr. Gharary's capable guidance, let us take a journey through the rich tapestry of articles gracing the pages of this issue. Within these pages, you will discover the richness and diversity within our field. This collection of articles exemplifies the journal's commitment to fostering meaningful discourse and advancing our understanding of the human mind and what it means to be a psychologist. Our review begins with our feature homestudy continuing education article, where esteemed editorial board member Dr. Anthony Tasso, along with graduate students and colleagues

Thank you once again for the opportunity to serve.

NJ Psychologist

Fall 2023

Executive Director Update

By Sara Tedrick Parikh, PhD NJPA Executive Director

My 8 months here have been full of slowly unfolding transitions, the most exciting of which has been restructuring Central

committees are quite popular in other state associations, and Dr. McGroarty and I are eager to launch this effort once we have enough committee members to reasonably distribute the workload. If you’d like to attend an Insurance Committee volunteer interest meeting in 2024 to learn more about the structure and commitment, please let me know at njpaed@psychologynj.org.

Office staffing to create a new position, Director of Operations (DOO). I’m so pleased to introduce our first DOO, Dr. Amy Chapman. Dr. Chapman is an educational psychologist who comes to us with a history of increasing nonprofit membership and growing events year-over-year. She believes strongly in the

With all the recent Central Office transitions, I have been asked how to reach the right staff member. My first answer is, if you guess wrong, we will happily route you to the correct person! We will transfer your call directly when we can, and otherwise we will have that staff member call you back. If you email us or leave a voicemail, we’re most likely to hand you off to the right person if you include a few sentences about what you need. One notable exception is our DPA, Dr. McGroarty, who does not have a Central Office phone line. Questions about practice issues should always be directed through our DPA Consultation Form, which allows Dr. McGroarty to plan out her Wednesday consultation hours and, when needed, research issues before speaking with members. Central Office staff are happy to assist with completing the form, but no one else in Central Office is qualified to answer practice questions.

power of relationships within professional associations, and she is committed to equity and justice. In addition to managing Membership and Foundation tasks, Dr. Chapman will oversee the growth of NJPA’s CE programming and support general operations of the association. She can be reached at njpadoo@psychologynj.org. Our current NJPA Central Office staff also include Christine Gurriere, Senior Communications Manager (njpacg@psychologynj.org); Kaleigh White, Events and Association Project Manager (njpakw@psychologynj.org); and Connor Neuhaus, our first NJPA intern (njpaintern@psychologynj.org). I have been so proud of our teamwork as we have worked through last summer’s license renewal cycle and this Fall’s membership renewal drive, both of

We have one more big transition that's ready to be shared: Relocating Central Office to Suite 2325 within the same building. This move will save approximately 25% on rent while maintaining essential functionality and access to larger meeting spaces within the building. The space is currently being built out, and we expect to move sometime in late 2023. Watch the Friday Update for more information about our anticipated move-in date and related closures as staff prepare for the move and unpack in our new space. We look forward to welcoming the association to meetings and events in our sleeker space in 2024!

which presented extra challenges due to our transition to a new website platform last winter. We are also reimagining hybrid and in-person events, both in terms of meeting members’ needs and navigating new realities in event spaces’ options and pricing. Look out for new approaches to NJPA events in 2024! I have also been working closely with NJPA’s Director of Professional Affairs, Dr. Susan McGroarty, to explore how to stretch NJPA’s resources to meet members’ needs in new ways. One much-anticipated initiative is an Insurance Committee, which could create a structure for committee members to track changes in coverage and reimbursement, share updates with the full NJPA membership, and flag group issues for member education and advocacy efforts. Similar member-run

Sara Tedrick Parikh, PhD

NJ Psychologist

Fall 2023

President's Message

By Briana Cox, PsyD NJPA President The most monumental change that occurred in 2023 was the hiring of our new executive director. In February, we welcomed Dr. Sara Tedrick Parikh as NJPA’s new Executive Director. I want to thank Dr. Tedrick Parikh for choosing us. We are most fortunate to have an Executive Director who shares our education, training, and values, and cares so deeply about the practice of psychology and the people we serve.

In my final presidential message to the membership, I want to express my sincere gratitude to everyone at NJPA who has dedicated their efforts to make NJPA stronger as an organization and more powerful in our advocacy efforts this year. I’d like to highlight some of the more important changes that have been made to the association and thank the people who made those changes happen. I am honored to have been a part of the work that has been accomplished at NJPA in 2023.

This month, we welcomed Dr. Amy Chapman as our new Director of Operations. The Director of Operations position was created out of a Central Office restructuring plan envisioned by Past president, Dr. Peter DeNigris to address growing membership and continuing education needs. Dr. Chapman comes to NJPA from the Collaborative for Spirituality in Education at Teachers College, Columbia University, where she served as Director. Dr. Chapman brings an expertise in non-profit administration, event planning and coordination, continuing education development, and grant management, among other incredibly valuable skills. I am delighted to welcome her to NJPA. Thanks to all who made this restructuring possible,

First, I want to thank the Central Office staff for weathering the many changes and transitions that NJPA has endured over the past two years. Our Senior Communications Manager, Christine Gurriere, who has been with NJPA longer than I have been a psychologist, has been nothing short of a miracle worker these last several months. She truly is the glue that holds it all together and we would be lost without her. Thank you, Christine. Thank you to Kaleigh White, who has done incredible work coordinating our continuing education programming, including our hybrid events, so that our members can continue to have multiple opportunities to access crucial CE content. And special thanks to NJPA’s first ever intern, Connor Neuhaus, who has provided much needed support through these transitions.

including our Executive Board and our Personnel Committee. This month, I also had the opportunity to attend the NJPAGS Internship Fair, which is organized solely by NJPA

After a long hiatus due to COVID, the Inter-Mental Health and Psychological Associations Coalition (IMPAC) began meeting again in January of 2023. I want to thank IMPAC members, Dr. Barbara Prempeh, Dr. Enmanuel Mercedes, and Dr. Jasdeep Hundal for partnering with NJPA to fulfill the mission of “promoting equality in mental health care and zealously advocating for the mental health needs of the diverse population of the state of NJ.” IMPAC is currently working on a conference, to be held in the summer of 2024, that will address access to care issues.

graduate students and supported by NJPA’s Director of Academic and Scientific Affairs, Dr. Marc Lombardy. I thank Jaclyn Hammond for her exemplary leadership as Chair. Under Jaclyn’s leadership, the NJPAGS committee is thriving and several NJPAGS members have secured representative positions in other areas of leadership at NJPA, including our Committee on Diversity and Inclusion (CODI) and our Committee on Legislative Affairs (COLA).

NJ Psychologist

Fall 2023

If you have enjoyed NJPA continuing education programs this year, please join me in thanking our CoCEA leaders and

service to the association. You will be missed. I also want to thank Past-President, Dr. Lucy Sant’Anna Takagi, for her friendship and mentorship. No matter how busy her own schedule was, Dr. Takagi generously gave her time to

Programming Chairs, Dr. Alexandra Miller Clark, Dr. Phyllis Lakin, Dr. Sharon Ryan Montgomery, and Dr. Marcy Pasternak. Special thanks to Past-Chairs, Dr. Mark Lowenthal and incoming NJPA President, Dr. Marc Gironda, who have been a force behind this important committee for many years.

provide important institutional knowledge and support. In the final months of the year, we will continue to engage in advocacy efforts to protect pay parity for telehealth in New Jersey. Whether or not you are providing services via

NJPA continues to assess how the association can best meet the needs of our Early Career Psychologists and believes that ECP representation is essential to meeting the association’s goals. As such, the eExecutive Board holds a voting position open for an Early Career chair to sit on the Executive Board. This position is currently vacant. I know that there are many challenges for ECPs, who are, by definition, beginning their careers. NJPA is dedicated to ensuring ECP access to leadership and accommodating whatever needs may arise. If you have graduated in the last ten years and would like to have a voice on behalf of your ECP colleagues, please consider joining our Board. ECP leaders have made significant contributions to NJPA this year. I must thank Dr. Stacie Shivers for her work on COCEA and Dr. Christopher King and Dr. Anastasia Bullock for their work on COLA.

telehealth currently, I implore you to help NJPA ensure that telehealth services are paid at a rate commensurate with in-person services. NJPA views this as a critical access to care issue in a time of mental health crisis for New Jersey. Our advocacy efforts are most effective when legislators and government officials hear from us in large numbers. Please be on the lookout for upcoming advocacy alerts and calls to action as we approach the December 31st when telehealth parity protections are set to expire. Thank you to our Government Affairs Agent, Jon Bombadieri for leading us through these efforts and to our Director of Professional Affairs, Dr. Susan McGroarty, who works overtime to ensure that our members interests are heard and protected. Thank you all for a productive and prosperous 2023. I look forward to seeing you at our Fall Conference on October 27th and 28th at the DoubleTree by Hilton in Somerset.

Finally, I want to thank the NJPA Executive Board for their dedication to the organization. I particularly want to thank Past-President, Dr. Peter DeNigris, for his vision and mentorship. Thank you to our parliamentarian, Dr. Bonnie Markham for ensuring that NJPA stays true to its mission and goals with the highest of ethical standards. Thank you to Past-Ppresident, Dr. Daniel Lee, who has remained available to fill in whenever NJPA has needed volunteers to get important business finished, despite the conclusion of his past-presidential term last year. Thanks to Dr. Dan DaSilva who is leaving the board this year after many years of

Briana Cox, PsyD

NJ Psychologist

Fall 2023

A Continuing Education Article

A Review of the Emotional and Academic Impact of COVID-19 on College Students (1 CE)

By Anthony Tasso, PhD

By Nesrin Hisli Sahin, PhD

By Nicole Perez, PhD

By Carly Pasquale

Earn 1 CE credit when you read this article and successfully complete the post-test. Purchase this CE activity here.

Introduction: The coronavirus (COVID-19) outbreak has wreaked havoc on society in a multitude of ways. Across the globe, businesses closed (with some never reopening), travel came to a halt, schools went virtual, children’s activities were put on hold, people masked, health care was strained, and much of the world worked remotely. And over 6.9 million people died from the virus (or complications from it) around the world (WHO, 2023). As such, the human toll of COVID-19 is vast, devastating, and, at this time, still to-be-determined. The ways in which the coronavirus period has affected college students is perhaps more nuanced than with other groups. For one, young adults are amongst the most biomedically robust from coronavirus sequelae (see Bajaj et al., 2021; Wong et al., 2020), yet have been significantly affected on academic and socioemotional levels. Specifically, most, if not all, college classes immediately converted to remote learning. This was unprecedented, with many students (and professors) forced to do so without any prior experience or training. Additionally, dormitories closed, requiring students to immediately change residencies, while social activities—central to university and young-adult life—came to a standstill. Even with vaccinations standard on most college campuses, social distancing, masks, and compromised social activities persisted well into the second year of the pandemic, accentuating the atypicality of college life. As such, this least medically vulnerable group experienced significant academic and social disruption. This article reviews the literature on the impact of COVID-19 on college students following the termination of worldwide COVID-19 emergencies, which coincided with year three since the emergence of the virus in the United States. Although there was no dearth of areas on which to focus, we circumscribed our review to how COVID-19 has affected college students’ mental health (i.e., depression, anxiety, substance use, sleep, social isolation, eating), as well as their experience with academics. This paper concludes with information on young adults’ coping and resiliency along with mental health treatment factors during this time. Mental Health Concerns about college students’ mental health expectedly accelerated during this pandemic. As such, numerous investigators examined COVID-19 facilitated depression, anxiety, fear, sleep, and disordered eating amongst this

NJ Psychologist

Fall 2023

population (Browning et al., 2021; Copeland et al., 2021; Dial et al., 2021; Fruehwirth et al., 2021; Krendl, 2021; Tasso et al., 2021). We first report on a prepandemiccurrent time study by Frazier et al. (2021). This investigation compared mental health data of US college students in 2017 (a pre-COVID ‘control’ group) to a separate group of US college students in April 2020, and reported an appreciable increase in stress and depression with the ‘COVID-19’ (April 2020) group.

believe they have been infected. The results indicated that college students who believed they may be positive for COVID-19 reported elevated levels of depression, anxiety, and post-traumatic stress symptoms. Research also examined college students’ experience with suicidality and disordered eating during COVID-19, with some data suggesting that those college students who were hospitalized for the coronavirus self-reported greater levels of suicidality than those college students who were not hospitalized because of their COVID-19 illness (DeVylder et al., 2021; Kaparounaki et al., 2020). Christensen et al. (2021) noted how the COVID-19 experience exacerbated disordered eating amongst college students in the United States who had prepandemic struggles with food insecurity, while additional evidence suggests that the pandemic resulted in poorer food choices (Powell et al., 2021). Furthermore, self-control and fear were linked to disinhibited, more unhealthy eating patterns during the pandemic (Li, Xiang, Song, et al., 2021).

Schepis et al. (2021) reported that depression and anger, but not insomnia, were slightly elevated following the closure of US universities. However, other research indicated that anxiety and sleep troubles were prominent during this time (Copeland et al., 2021; Kibbey et al., 2021; Kim et al., 2021; Oh et al., 2021; Tasso et al., 2021; Tomaszek & Muchacka-Cymerman, 2022), especially for those who contracted the virus (GoldrickRab et al., 2022). Boundtress and colleagues (2021; 2022) empirically identified fear of exposure to the virus, worry, housing/food instability, and substance use as pivotal in college students’ mental health struggles. Krendl (2021) identified that pandemic-related stress exacerbated college students’ pre-existing mental health conditions. College students' emotional well-being during the pandemic has also been examined on a global level. Chang et al. (2021) meta-analysis revealed that college students around the world experienced elevated levels of anxiety and depression, while Chinese college students reported on overall distress and depression, owning to both the fear of becoming sick and the abrupt change to virtual schooling (Yang et al., 2021; Yu et al., 2021). More recent research revealed that Chinese college students, with a history of childhood abuse or neglect, experienced significantly more psychological distress than those without such histories (Zhu et al., 2022).

Relationships and social relatedness were substantially challenged during the pandemic. As such, loneliness and isolation were additional concerns amongst college students and others during COVID. Investigators (Okado et al., 2021; Tasso et al., 2021; Vaterlaus, 2022) reported that more than half of United States college students experienced loneliness and social disengagement during the pandemic. Furthermore, Koelen et al. (2021) noted that emotionally at-risk university students experienced an increase in loneliness and an exacerbation of preexisting mental health symptoms during the early stages of the stay-at-home orders. This same study also reported that perceived social support helped mitigate the detrimental mental health effects of the COVID-19 experience. Interestingly, Krendl (2021), however, found that loneliness was unrelated to mental health with this American college population.

Saha et al. (2021) conducted in-depth qualitative interviews with university students in Bangladesh, with findings suggesting that college students experienced a range of distress at the start of the pandemic. Additional Bangledeshian research (Sultana et al., 2021) quantitatively explored COVID-19 related mental health symptoms by comparing a group of college students’ psychiatric symptoms, who believed they were possibly infected with the coronavirus with those who did not

Gender differences, vis-à-vis experience of the pandemic, have also been subjected to study, with data suggesting more pronounced unfavorable impact of COVID-19 on college women than men (see Chang et al., 2021). Browning et al. (2021) noted that American college women self-reporting poorer prepandemic physical health (e.g., general health status, BMI), who spent more than eight hours using technology, had

NJ Psychologist

Fall 2023

greater deterioration of their emotional well-being. Other investigators also suggested that college women are more vulnerable to COVID-19 psychological distress in the United States (Fedorenko et al., 2021), Italy (Amerio et al., 2022), France (Bourion-Bedes et al., 2021), and Poland (Rogowska et al., 2022). Other evidence, however, suggests that college men are more prone to coronavirus-related distress than college women (Sanchez et al., 2020; Vigo et al., 2021).

Turkish college students (Duran & Erkin, 2021) along with prolonged sleep durations with an Israeli college sample (Pan et al., 2022).

The deleterious effects of the pandemic on college students were also particularly noted in students of color and other students with minority statuses studying

prepandemic mental health struggles were related to pandemic-based increase in alcohol consumption amongst college students. An increase in alcohol use

in the United States (McCurdy et al., 2023; Lancaster & Arango, 2021; Lopez-Castro et al., 2021; see Ferreira,

amongst college students during the pandemic was associated with a deterioration of overall mental health

2021; Salim, 2021). Evidence suggests that sexual and gender minority college students experienced heightened psychological duress, suicidality, and alcohol

(Ryerson, 2022). Schepis et al. (2021) revealed selfreported increases in alcohol and cannabis use, respectively, during the onset of COVID-19 in the United

use during the peak of the pandemic (Dyar et al., 2021; Gratz et al., 2021; Salerno et al., 2021), while Hunt and colleagues (2021) found that gender diverse college

States, while Papp and Kouros (2021) also identified increased alcohol, cannabis, and prescription drug misuse amongst college students during the very early

students in the United States exhibited less resilience and greater mental health distress than their male and

stages of the stay-at-home orders. Ryerson and colleagues (Ryerson et al., 2021) found that American

female counterparts. COVID-related anxiety and depression were also deemed elevated in US female,

college students, who were over the legal drinking age returning home, drank more while those under the legal

LGBT, and gender diverse college students (Gonzales et al., 2020; Hoyt et al., 2021) in addition to evidence that LGBTQ students of color, forced to return home

drinking age returning home drank less alcohol.

following the closures of US dormitories, experienced greater propensities for identity concealment (Salerno et

or even a decrease, in college-student alcohol use as a function of fewer social activities (Bollen et al., 2021;

al., 2022).

Bonar et al., 2021; Fruehwirth et al., 2021). Jaffe et al. (2021) studied the alcohol consumption patterns of college students at an American university by comparing the initial semester impacted by the coronavirus (Spring 2020) to Spring 2019 and Spring 2018 semesters (control semesters), with results suggesting an appreciable reduction of alcohol consumption amongst college students during the pandemic-stricken semester. Further analyses from this same dataset indicate an even greater reduction of drinking reported by those college students who were forced to change residences due to the pandemic compared to those who did not change their living arrangements. A similar reduction of smoking and vaping was again attributed to students leaving their campus residences (Sokolovsky et al., 2021). Jackson et al. (2021) also reported a reduction of peer/social alcohol consumption amongst US college students at the

Substance Use Substance use and abuse, an omnipresent concern on college campuses, pandemic or not, has been comprehensively studied during these past three years. Coakley and colleagues (2021) reported on how

Other research, however, found only a minimal increase,

Sleep Concerns abound regarding COVID-related sleep disturbances amongst university students. Multiple American-based studies found that pandemic-related anxiety facilitated compromised sleep (Kowalsky et al., 2021; Tasso et al., 2021; Ulrich et al., 2021). However, other investigators (Benham, 2020; Schepis et al., 2021) found no sleep disturbances with American college students during the early stages of the pandemic. Independent Chinese-based investigations indicated that college students experienced significant sleep issues (Liu et al., 2021; Ye et al., 2021; Zhang et al., 2021). Sleep disturbances were also found in a sample of

NJ Psychologist

Fall 2023

onset of the pandemic, though an uptick in consumption with family members.

We included a brief review of the literature of college students’ personality styles and their possible mediating role with the COVID-19 experience. We studied

motivation and performances amongst those students enrolled in an American university born out of COVIDrelated psychological distress (Kecojevic et al., 2020; Usher, et al., 2021). Research also suggests that college students experienced difficulties with attention and sustained focus when colleges converted to remote learning (Hicks et al., 2021). Gonzalez-Ramirez et al. (2021) reported on college students’ increased cynicism and academic challenges due to technological problems,

personality characteristic as both a means to better understand those young adults with a greater penchant

as well as social disengagement, during this aspect of the college learning process. We (Tasso et al., 2021) also

for pandemic-based emotional duress along with academic struggles.

noted that American university students experienced a range of academic-based distress, concerns, and complications during the first COVID-19 semester.

College Student Personality Styles, Mental Health, COVID-19

Rettew et al. (2021) highlight the role of personality styles and their impact on COVID-related stress, with

Evidence also indicates that minority college students

evidence suggesting that extroverted college students experienced greater levels of distress during the pandemic than those identifying as introverted. A study

have particularly suffered with the academic process during COVID. Ober et al. (2021) suggests that minority US college students reported more negative attitudes

from Spain revealed that those students with rigid personality styles reported more severe psychological

about the transition to remote learning than nonminority students, while Marler et al. (2021) noted

distress during the past two years than those Spanish college students who were less rigid (Hernandez-Lopez

that those university students self-identifying as lower SES experienced the greatest amount of COVID-19

et al., 2021). Additionally, productive self-regulatory abilities have been linked to more controlled, healthy

related distress, resulting in a significant drop in academic motivation and disengagement from their

eating patterns during the pandemic (Li, Xiang, Song, et al., 2021). Research also suggests that students, who struggle with uncertainty or the unknown, were

academic institution. Similar results were also reported in the UK (Aristeidou & Cross, 2021) along with remote learning struggles with a Jordanian college student

particularly vulnerable to psychological distress owning to the unclear trajectory of the coronavirus (White,

population during this period (Maqableh & Alia, 2021). Data from Spain, however, revealed that college

2022). Tasso et al. (2021) noted that boredom was prominent during the immediacy of the pandemic for US college students. This can be particularly troubling in the light of related research indicating that college students reporting pandemic-based boredom have a greater propensity for risk-taking behaviors (Cohen et al., 2021).

students’ academic performance improved, owning to their decreased social activities along with a greater ability for continuous study (Gonzalez et al., 2020). College Student Personality Styles, Academics, COVID19 In addition to exploring college student personality styles and COVID, investigators have also touched on the roles of personality and academic experiences amongst college students during COVID. Rational, problem-solving styles were predictive of COVID-time academic motivation (Gunaydin, 2022), along with less associated academic distress (Keyserlingk et al., 2021). Audet et al. (2021) empirically identified that trait openness is the personality style most related to greater adaptability to college online learning and self-reported

Academics Researchers also homed in on college students’ educational experience during the pandemic. The aggregate of these overall findings suggests poorer college academic performances in concert with greater academic-related distress both stateside and abroad (Madrigal & Blevins, 2021). Specifically, different investigators reported on the decreased academic

NJ Psychologist

well-being during the pandemic, while Besser et al., (2020) reported on the proactive effects of a flexible personality on academics during remote learning amongst Israeli university students. College Students, Resiliency, and COVID-19 The primary emphasis of this review paper was to overview the deleterious socioemotional and academic impact the first three years of the COVID-19 time period on college students. The inclusion of resiliency and coping within this paper is to offer professionals working with college students a richer understanding of how to plausibly differentiate those most at risk for psychological decompensation in concert with a possible pathway to facilitate greater emotional wellness. Therefore, in addition to the systematic examination of the seemingly difficult emotional and academic reactions college students experienced due to the coronavirus pandemic, an overarching goal of our review paper, many investigators have also worked to identify coping and young-adult resiliency factors. Resiliency, broadly viewed as the personal capacity to withstand or even thrive when faced with adversity, has been a fruitful topic of study during the COVID time period (Chen & Bonnano, 2020; Chirico & Nucera, 2020; Di Giuseppe et al., 2020; Iimura, 2022; Sturman, 2020; Zhu et al., 2021). Data suggest that American college students with greater levels of hope, gratitude, and a propensity to physically protect themselves from COVID experienced lower levels of pandemic-related distress (Ang et al., 2022). A sense of connectedness to one’s college is also identified as a buffer from mental health and academic struggles during this coronavirus period (Gopalan et al., 2022). Analyses of a South African college sample suggests that those who purposely spent time with family, friends, and engaged in spiritual actives fared better in managing the range of struggles during this pandemic (Eloff, 2021), while Chinese university students who were physically active during this period experienced less COVID-related anxiety and depression (Xiang et al., 2020). Li, Li, & Fan (2021) identified how emotional awareness helped Chinese college students during the pandemic, and Ye et al. (2020) reported how some Chinese college students in the throes of COVID who were able to utilize an array of proactive socioemotional resources were best-able to cope with the distress. Additionally, Goncalves et al. (2021) indicated that Brazilian college students with

Fall 2023

resiliency propensities were more safeguarded from the deleterious psychological effects of COVID-19. Kuhn et al. (2021) further illuminated the productive effects of resiliency in managing the difficulties during this coronavirus experience. The buffering effects of social relationships and COVIDbased distress has emerged in the empirical literature. Mayorga et al. (2021) discussed the link between loneliness and worsening mental health amongst American college students, while data from an Italian college (Nola et al., 2021) reported on how relationship quality and social support along with self-motivation and clear personal interests had demonstrable mitigating effects to COVIDdriven anxiety. Research also suggests that resilience, social support, and coping abilities helped counter loneliness experienced by college students amongst a Philippine sample (Labrague & Ballad, 2021; Labrague et al., 2021; Ryerson, 2022), while others (Zhang et al., 2022) reported that positive parent-college student communication and support helped insulate COVIDrelated emotional duress. This effect was greatest for first generation college students (Jeong et al., 2021). References Furnished Upon Request

Earn 1 CE credit when you read this article and successfully complete the post-test. Purchase this CE activity here. About the Authors Carly T. Pasquale is a graduate student at Fairleigh Dickinson University studying clinical mental health counseling. She interns at a private practice in Morristown, NJ. Her clinical interests include chronic health issues, grief/loss, trauma, and phase of life transitions. Nicole Perez, PhD, is a clinical psychologist who runs a private practice in Knoxville, Tennessee. She specializes in the treatment of adult professionals and their families. She also conducts forensic work with both the court system and private law practitioners. Nesrin Hisli Sahin, PhD, is an adjunct Professor of Psychology at the School of Psychology & Counseling, Fairleigh Dickinson University. She also has a psychotherapy practice named Center for Stress Management in Morris Plains, Morris County, NJ. Anthony F. Tasso, PhD, is a Professor of Psychology and Deputy Director of the School of Psychology & Counseling, Fairleigh Dickinson University. He also has a psychotherapy practice in Whippany, Morris County, NJ.

NJ Psychologist

Fall 2023

Harm Reduction is Health Equity: Navigating and Improving Accessible Treatment for Individuals With Eating Disorders and Substance Use Disorder in a Post-Pandemic World

By Alexis Libert and Jonathan Sepulveda, PhD Introduction

integrate HR with virtually delivered treatment for those with ED/SUD. This is vital to improve the accessibility of equitable care by reducing common barriers to treatment, including stigma, harmful physician beliefs, financial limitations, minority status, and location constraints (Thompson & Park, 2016). We argue that the delivery of future mental health treatment needs to accommodate for increased accessibility through virtual platforms, while simultaneously integrating and valuing HR as a legitimate supplement to evidence based interventions.

Before the pandemic, the lifetime prevalence of individuals diagnosed with substance use disorder comorbid with an eating disorder (ED) was 21.9% (Bahji et al., 2019). Since the start of the COVID-19 pandemic, ED symptomology has worsened, and alcohol consumption has increased (Alpers et al., 2021; Schlegl et al., 2020). EDs and SUD are a common comorbidity (Kerrigan & Attia, 2017). Those with comorbid ED/SUD present distinctly from those with solely an ED diagnosis on a variety of factors including the likelihood of being prescribed mood-stabilizers, impulsivity, temperament, emotion regulation, and more (Claudat et al., 2020).

ED/ SUD Comorbidity Binge eating disorder (BED), anorexia nervosa (AN), and bulimia nervosa (BN) are all associated with an elevated lifetime prevalence of alcohol and drug use disorders (Udo & Grilo, 2019). Of individuals diagnosed with AN specifically, between 15-20% will develop severe and enduring anorexia nervosa (SE-AN) (Fichter et al., 2017; Steinhausen, 2002, as cited in Yager, 2020). Women with alcohol use disorder (AUD) are more likely to have ED diagnoses and ED symptoms (MunnChernoff et al., 2020). Additionally, co-occurring AUD/nicotine disorder (ND) elevates mortality risk for those with AN (Franko et al., 2013). Individuals with EDs are shown to be more likely to consume alcohol, diet pills, cannabis, hallucinogens, opioids, sedatives, stimulants, and engage in polysubstance use, with these findings elevated across all ED diagnoses compared to a control group (Root et al., 2010).

Individuals diagnosed with EDs and/or SUDs, who cannot access or are unable/unwilling to conform to traditional treatment methods, deserve flexible and accessible treatment. The harm reduction (HR) approach promotes autonomy, compassionate care, trust in providers, and can save, or prolong, lives while improving the individual’s quality of life (Bianchi et al., 2020). Given the increased vulnerability of individuals with an ED and/or SUD during the pandemic, improved prevention and intervention was needed, but access to HR was reduced (Cooper et al., 2022; Noyes et al., 2021). The need for improved and more accessible and equitable care for vulnerable individuals endures into the post-pandemic world, and HR is an important component of care for those with EDs and/or SUD. In a post-pandemic world, with significant virtual advancements, it is important for clinicians to

EDs and SUDs come with a host of physical complications that are often absent in other mental illnesses. These include cardiac, pulmonary,

NJ Psychologist

Fall 2023

gastrointestinal, neurologic complications, and more (Westmoreland et al., 2016; World Health Organization, 2019). For individuals that experience this particularly insidious comorbidity, these complications can compound, leaving the individual exceptionally vulnerable and in need of competent and quality treatment to mitigate or alleviate the harm caused by the ED and/or SUD diagnosis. The pandemic has highlighted the need for increased equitable and accessible care. Additionally, virtual and telehealth simultaneously gained momentum as delivery options in mental health care during the pandemic. Treatment Despite the significant prevalence of AN, BN, and BED, only 34.5%, 62.6%, and 49.0% of individuals with these respective diagnoses ever sought treatment (Coffino et al., 2019). Additionally, men and ethnic/racial minority individuals are less likely to seek help for certain ED diagnoses (Coffino et al., 2019). The delay in seeking treatment and the duration of time an ED goes untreated corresponds adversely with the likelihood of remission (Austin et al., 2021). Ali et al. (2019) found “concern for others, self-sufficiency, fear of losing control, denial and failure to perceive the severity of the illness, and stigma and shame” as the most frequently cited barriers to helpseeking for young adults with ED symptomology (p. 894). Generally, for individuals with EDs who are refusing treatment, there are three available options: to convince them to try to engage in treatment; refuse to treat them if they do not comply with traditional treatment approaches; and treat them involuntarily, or in severe cases, offer palliative care—a controversial approach (Bianchi et al., 2020). HR is an additional treatment option for individuals with EDs who are unwilling, or unable, to comply with traditional treatment approaches (Bianchi et al., 2020). Contrary to traditional ED/SUD treatment approaches, which emphasize complete abstinence from SU and ED behaviors, HR is described as meeting individuals where they are, emphasizing symptom reduction to maintain a specific level of functioning that permits an acceptable quality of life (Bianchi et al., 2020). Traditional ED treatment approaches can have adverse consequences on individuals with persistent EDs who both express a desire to improve their life while also simultaneously engaging in ED behaviors. Bianchi et al. (2020) summarized the dilemma traditional programs experience when individuals with persistent EDs may: strive to achieve a better quality of life while continuing to engage in symptoms poses a challenge if eating disorder programs only treat individuals who are striving to achieve complete recovery and maintain an asymptomatic life, even after many unsuccessful attempts of trying to fully recover (p. 49). Application of HR for ED/SUD Treatment The traditional approach to treating EDs is focused on the complete alleviation of symptoms and disordered behaviors; therefore, it is not surprising that there is limited available research on HR for EDs. Given the compounding complexities of comorbid diagnoses, it is

NJ Psychologist

Fall 2023

particularly relevant to consider for individuals who experience both disorders concurrently. In addition to the disorders presenting more complexly and severely, for those with ED/SUD, the inadequate treatment options become narrower. Few treatment facilities are equipped to deal with dual diagnoses.

HR and the COVID-19 Pandemic Although specifically exploring HR in the context of substance use, Radfar et al. (2021) found that during the COVID-19 pandemic, HR practices were negatively impacted in a time that were more needed than ever. The study highlighted numerous issues that needed to be addressed more efficiently, but particularly relevant in the context of ED/SUD comorbidity was the need to integrate HR with other treatment approaches. This indicated that addiction medicine was globally affected by the pandemic: these findings highlight the fact that harm reduction initiatives should be seen as an integral part of an evidence-based treatment program and not as an adjunct to failed treatment [….] Service providers should be considering identifying person-centered, continuous care provision in all therapeutic options available (harm reduction initiatives included), especially during pandemic situations (Radfar et al., 2021, p 11).

In public health terms, HR would be viewed as a tertiary intervention; that is, it is a last resort treatment designed to reduce the damage being done by an illness, rather than reverse the damage (Bermudez et al., 2020). In the words of Yager (2021): Appreciating the dictum that ‘The perfect is the enemy of the good,’ harm reduction… help patients who cannot or will not reach ideal healthy weights, maintain their weights at life-sustaining levels, who cannot or will not totally abstain from binge eating and purging suffer fewer episodes, who cannot or will not abstain from consuming alcohol or other harmful substances decrease their intake, and who cannot or will not abstain from other self-injurious behaviors reduce their frequency and intensity to mitigate damage (p. 57).

It also highlighted and exasperated mental health struggles and inequity—including socioeconomic and racial health disparities (Nana-Sinkam et al., 2021; Vindegaard & Benros, 2020). However, in a postpandemic world, clinicians, and future clinicians, can take advantage of the positive strides made in the virtual delivery of mental health treatment (Cosh et al., 2022). In this modernized field of virtual mental health, it is important for clinicians to approach case conceptualization with the same individualized and evidence-based approach as before the pandemic and work on the adaptation and integration of HR into their virtually delivered therapeutic services.

Russell et al. (2019) proposes that “harm minimization, physically and mentally, is key to working with chronic, long standing [EDs]” (p. 391). Bermudez et al. (2020) explores this concept, explaining that HR “efforts should be driven by the desire to individualize care, recognize and respect self-determination in competent patients, and meet patients where they are in their perception of their illness and desire or readiness for change” (p. 179). Individuals seeking mental health treatment face numerous barriers to equitable care, and those with comorbid ED/SUD face a host of disadvantages that are amplified for this unique combination. This includes the difficulty of finding not only affordable treatment, but treatment that is equipped to address and treat both the ED and SU. The delivery of HR offers an individualized approach that promotes both autonomy and dignity for the individual by allowing them decision making power and validating the function that their ED behaviors and SU may fulfill. Integrating HR with evidence-based practices, and accommodating for virtual delivery, can allow individuals who would not otherwise be able to access treatment to improve their quality of life. It can also be delivered at an outpatient level, allowing for more affordable treatment, and permitting individuals to continue to meet their existing responsibilities. HR is neither palliative care, nor hospice, but rather an opportunity for individuals with persistent and cooccurring ED/SUDs to have access to flexible, individualized, and life-saving treatment.

HR as Health Equity HR is not only a valuable treatment approach for its compassionate nature and respect for autonomy, but it is also a key piece of equitable mental health delivery and social justice in the field. Social determinants of health play an important role in the development and maintenance of ED/SUD. Recognizing that many individuals cannot afford to enter higher levels of care is a first step in the development and delivery of more equitable care. Inpatient stays for individuals with a comorbid ED and SUD are the most expensive, and longest, of mental and substance use disorder (MSUD) hospitalizations, averaging $19,400 a stay, and nearly two weeks in length (Owens et al., 2019). ED inpatient care can average $2,295 a day, while partial hospitalization can average $1,567 a day (Guarda et al., 2017). The tremendous expense of treatment combined with the traditional treatment focus on complete

NJ Psychologist

Fall 2023

eradication of behaviors, makes adherence an unlikely possibility for many individuals.

treatment, or aspires to completely abstain from their symptomatic behavior.

The exorbitant nature of medical and mental health treatment expenses demands that alternatives to traditional treatment approaches be explored. Given the implications of social determinants of health in the development of EDs and SUDs, the concept of HR is more than just a treatment modality, it is an effort at improving equity. Equity, or justice and fairness, is not found in traditional and cost prohibitive treatment settings that cater to a middle and upper middle-class individual’s demographic using a narrow conceptualization of health. While for many, with EDs and SUDs, these systems have been lifesaving, many others will never have the privilege of accessing them. Instead, providers can be more flexible with their conceptualization of health and expand beyond ineffectual and arbitrary measures like BMI to categorize an individual’s well-being (Gutin, 2016). We must collectively understand that individuals with intersecting identities that differ from our own may not benefit from the existing systems in the way we anticipate. This demands the consideration that not everyone can access treatment, wants to access

Conclusion Regarding research, the existing literature on HR is already sparse, and what does exist largely focuses on persistent EDs. The equitable approach of HR allows for all individuals to access treatment—not just the ones who are able to afford, comply with, or accept traditional treatment approaches. Future research should focus on exploring HR as a treatment for comorbid ED/SUD. References Furnished Upon Request About the Authors Alexis Libert is a third-year student in the counseling psychology doctoral program at Felician University. She holds a BS in Psychology, with a concentration in Addictions. Her research and clinical interests focus on the development, dissemination, and delivery of more accessible and equitable eating disorder treatment. Jonathan Sepulveda, PhD, is an associate professor in the Department of Graduate Psychology at Felician University. His research focuses on the impact of ethnic and racial identity, anti-racism, purpose, and mentorship.

Member News Ruth Lijtmaer, PhD presented the following: * Panel: Where is our Humanity: Three Latina Women Psychoanalysts Discuss Dehumanization, Gender and Immigration. Paper: How Human Are We? Reflections on Malevolence and Paranoid Fantasies. Presenter and moderator. Division 39, APA, 4-26-23 to 4-29-23. New York, NY. * Paper: Evil Spirits and the Feared "Other." International Psychohistory Association (IPA). Conference Theme: What on Earth is Going On? Psychohistorical Perspectives on a World on the Edge. 5-18-23 to 5-20-23. HYBRID * Paper: Immigrants as Viruses That "Destroy" the Countries and are Dehumanized. Naxos Greece. 5-26- 23 to 528-23 Joint Conference Adelphi Psychoanalytic Institute & NYU Post Graduate. * Paper: The Dangerous "Others.” Fear of the Virus and Fear of Immigrants; Both Unwelcome Children to be Removed. Conference theme: International Ferenczi Conference. 6-9-23 to 6-11-23. Budapest, Hungary. * Paper: Demonizing the "Other" and Wishing to Destroy It. In panel: Devil and Good; Love and Hate: Who is the Other?. Conference theme: Meeting the Other. Relational Psychoanalysis in Dialogue with Multiple Perspectives. IARPP 6-15-23 to 6-18-23. Valencia, Spain. Latest publications: Can we imagine a world without walls? Journal of the Association for Psychoanalysis of Culture and Society. Springer Nature. On Line Journal 3-1-23 The absence of Women in classical music. Clio's Psyche, 29,3, 348-351 No apologies. Unfinished business and the Pact to Forget. IFPE’s Other/Wise: Selected Papers From the 2022 IFPE Conference, "Disruptions and Transformations.” Issue 1 Spring 2023. www.IFPE.org

NJ Psychologist

Fall 2023

Training “Competent” Clinicians: How to Ensure Psychologists are Meeting the Ethical Guideline of Practicing within the Boundaries of Competence

By Melissa Conway, PhD Member of NJPA Ethics Committee The idea of “competence” is ingrained in APA’s Ethical Guidelines. As psychologists, our ethical guidelines require us to provide only services that fall within the boundaries of our competence, based on our “education, training, supervised experience, consultation, study, or professional experience” (APA Ethical Guidelines, Section 2.01). When we do not have the competence to treat certain populations or disorders, the guidelines require us to obtain training or supervision in advance of providing our services. If we have closely related skills, we can provide services so long as we are doing what is necessary to obtain competence through additional training, research, or study. Only in case of emergency where there are no alternatives for mental health care can we practice outside of our competence, and this practice should cease as soon as the emergency has ended or more appropriate services become available (Section 2.02).

“competence” and to make that decision based on vague criteria, which is concerning given the impact our work can have on patients seeking out help from professionals who they assume will have the knowledge and skills necessary to offer appropriate treatment. As we think about assessing our own competence, here are some steps we should take and factors to consider to make it more likely we are meeting our ethical guidelines: 1. Don’t reinvent the wheel - Although there is no one criteria used to assess competence, there are preexisting resources that psychologists can leverage to help evaluate and improve their own competence in a particular area: (1) seek out information on the empirically-based treatment options for a particular disorder (a list of many of these treatments can be found here); (2) if you are working within a recognized specialty area (a list of specialties recognized by the APA can be found here), look for and consider pursuing a certification for the specialty (such as those offered through the American Board of Professional Psychology); (3) seek out well-regarded trainings and books that cover the specialty; and/or (4) obtain supervision from psychologists who have relevant expertise. If you don’t know where to start, consulting with other professionals who specialize in the field can provide you with next steps to take in terms of increasing your own competence.

In the medical field, the American Board of Medical Specialties and its member boards have established rigorous criteria for doctors to be certified in particular specialties and subspecialties, and board certification is often required to obtain hospital privileges or to participate in insurance. Not so with psychologists. Most doctoral training programs provide generalist training and many psychologists only specialize in more specific areas of our field after they finish their schooling. While the American Board of Professional Psychology offers certifications for certain specialties, including neuropsychology, addictions, serious mental illness, and forensic psychology, among others, these certifications are not always required to practice in these fields. Additionally, although we are obligated to fulfill continuing education requirements, there is leeway as to what courses we can take to do this. As a result, psychologists are often left to determine our own

2. Keep up with the times - Building competence should be a continuous part of one’s career. Part of being competent is staying abreast of new research and advances in your field. An easy way to do this is to select continuing education courses that build the skills you need to best support the specific populations that you serve. When time and financial resources allow, attend relevant conferences or seek

NJ Psychologist

Fall 2023

out additional training opportunities.

not see improvement when working with a certain population or disorder, it is probably time to increase your competence in that area or refer to those who specialize in it.

3. Crowdsource trainings, not treatment - Your networks of therapists (through psychology association listservs, social media sites, etc.) can be great resources for increasing competence, when used appropriately. Seeking out information about upcoming workshops, trainings, recent research studies, and books or articles to read about a particular population or treatment can enhance your skills. You can also use individual and group supervisions and peer consultations to increase competence. On the other hand, seeking suggestions from a listserv or other forum on how to support a patient with an issue about which you lack relevant expertise generally is not an appropriate way to develop the competence necessary to treat that patient.

6. And how does that make you feel? - Be sure to pay attention to your own feelings that arise around the work you are doing. Do you feel lost or confused in sessions? Do you feel clear about the next steps you should be taking in treatment? Are there other feelings that might be getting in the way of assessing your own competence and taking the appropriate steps? If you are a newer therapist, you might need to challenge your own feelings of “impostor syndrome” that could lead you to question your abilities in general and feel like you should be referring out even when you have the appropriate training and skills. Alternatively, if you are in private practice and your income is dependent on seeing a certain number of patients, or if you work in an environment where you are expected to see patients assigned to you or meet a quota, you might be feeling some reluctance to refer someone out. Ensure that you are aware of any biases, conflicts of interest, or other issues that may prevent you from being honest with yourself about your own competence.

4. Always be assessing - Assessing one’s own competence should be an ongoing, active process. At the outset of providing services, a thorough assessment should be done about the patient’s current symptoms as well as their history, so that a psychologist can identify potential issues related to competence. For example, a psychologist may decide that a patient with a significant history of an addiction or eating disorder would be better off being referred to someone with a specialty in those areas even if it is not the presenting problem. As you work with a patient, if they reveal additional issues or symptoms that are outside of your area of competence, you need to determine whether you can gain the competence necessary to continue to treat them or whether the patient is better served by being referred to another provider.

Keeping these strategies in mind allows psychologists to put the vague guidelines around competence into practice in a concrete way that benefits the populations they serve. Not only does it minimize the risk of harm to those you are working with, but doing so also reduces the risk of legal or professional repercussions from practicing outside of your competence. About the Author Melissa Conway, PhD is a licensed psychologist and member of the NJPA Ethics Committee. She is the co-founder of North Jersey Psychology Associates, which specializes in the treatment of adults and adolescents with anxiety disorders and OCD.

5. How does your patient feel? - Are your patients reporting progress? Are they seeing good results from treatment? This should not be the only thing to consider in assessing your competence, but it can and should be a factor. If you consistently do

NJ Psychologist

Fall 2023

Do You Have Headphones For Your Tablet? Clinical Considerations For Providing EvidenceBased Trauma Focused Teletherapy to Children and Their Families

By Kristine Hodshon, PsyD (l) & Elizabeth McIntyre, PhD (r)

Teletherapy: An evidence-based tool for delivering trauma-focused mental health services Childhood exposure to potentially traumatic events, including experiencing or witnessing abuse, is a prevalent issue that places children at risk for various impacts to their functioning across behavioral, emotional, academic, and social domains (Hanson et al., 2018). Evidence-based practices for addressing childhood trauma include Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), the efficacy and effectiveness of which has been well documented by numerous randomized trials (Cohen, et al., 2017; Deblinger, et al., 2015). Trauma-exposed children and families can experience the same barriers to accessing effective mental health treatment that many individuals face. Video-conferenced mental health services (“teletherapy”) provide a means for navigating many of these barriers. What’s more, there is a compelling evidence-base for the use of teletherapy for mental health treatments in children. Within the population of trauma-exposed children and youth specifically, teletherapy delivery of TFCBT has been associated with post-treatment outcomes equivalent to those found when TF-CBT is delivered inperson with meaningful post-treatment outcomes and, although understudied, there is some evidence indicating the feasibility and acceptability of TF-CBT teletherapy among service providers (Stewart et al, 2017; Stewart et al, 2020). Teletherapy delivery of evidence-based treatment provides an option for navigating many of the logistical barriers to treatment engagement that families

experience, including transportation and travel time, employment barriers, and clinician availability. Some features unique to teletherapy can also promote treatment adherence, such as the ability for children and families to engage in treatment from a setting in which they are comfortable, the home. Teletherapy delivery of evidence-based traumafocused treatments for children does require the careful use of clinical judgment, as this format also has potential risks to treatment adherence, engagement, and delivery. Structuring sessions to ensure a confidential treatment space in which children and caregivers can speak openly about their experiences can be difficult when clients are participating in teletherapy from home. In trauma-focused treatment for children and families, it is all the more critical to ensure privacy for discussing sensitive subjects that may involve members of the family, such as by providing headphones for use during sessions. The flexibility of teletherapy may inadvertently encourage participating in treatment from non-confidential spaces, such as in the community or in the car. Access to reliable technology, including Internet connections, devices, and HIPAA-compliant video-conferencing platforms, can pose challenges for clients and treatment providers alike. Furthermore, learning to navigate what may be new technology for children, caregivers, and treatment providers can be difficult, especially when treatment providers are not in the same physical space as clients to provide direct support.

NJ Psychologist

Fall 2023

where the child would participate in treatment with a parent, who has been physically abusive or is at risk of physical abuse of their child, have additional challenges with teletherapy service delivery. The issues of confidentiality discussed above become particularly salient, as it may be essential to the comfort and/or safety of the child to be able to have conversations about their experiences involving their caregiver without that caregiver overhearing them.

The need for navigating barriers to accessing treatment and minimizing the risks of teletherapy became all the more important with the onset of the COVID-19 pandemic. At the height of this public health emergency, the necessity of social distancing meant that agencies and families had to address these barriers while also protecting public health (and experiencing a community-level trauma in itself, the pandemic). Using the evidence-base for teletherapy, mental health providers around the globe were led to develop processes and procedures for implementing it well. As such, there is a wealth of insight into the practice of establishing teletherapy service delivery. As our experience of the COVID-19 pandemic is shifting, there is a need for examples of navigating the risks of teletherapy and maximizing its benefits to enhance and scale evidence-based mental health practices in this medium.

Clinical considerations for teletherapy Through the almost three years that our clinicians have been providing teletherapy services, we have found various clinical considerations that may be helpful to keep in mind with providing teletherapy treatment for children who have experienced abuse, neglect, and/or other traumatic experiences and their families. First, the time that it takes to complete aspects of intake and treatment may take longer utilizing teletherapy than they would in-person. Prior to the first session, we have found it to be helpful for the clinician to contact the caregiver by phone to solve any initial issues with accessing the teletherapy platform. This often helps ensure that considerable time in the first intake session is not spent troubleshooting accessibility issues. Additionally, as part of our intake assessment, clinicians administer several standardized measures to obtain information about a child’s emotional and behavioral functioning. When in-office, several of these measures can be completed by the caregiver and/or older child/adolescent on their own. However, via teletherapy, measures need to be read aloud to the child and caregiver. This often takes considerable time and should be considered when planning for an intake session. Similarly, increased time should be planned to complete mid- or post-treatment assessment measures.

With pandemic-related lockdowns, our program developed systems and procedures for teletherapy that have maintained our commitment to providing evidence-based treatments for trauma to children and families. In deciding whether to engage a family in teletherapy or in-person services, the conversation may include a discussion on the risk and benefits of inperson, as well as teletherapy and technological requirements, to participate in teletherapy services, as outlined above. One may also consider the specifics of the case, such as the level of contact with an alleged perpetrator and custody agreements as part of a divorce. When a child has been exposed to domestic violence, one may also consider the child’s contact with the perpetrator of the violence and whether this individual has successfully completed domestic violence treatment. Completion of such treatment helps to ensure the physical and emotional safety of the child while processing this traumatic event.

Relatedly, an important clinical consideration involves handling safety issues. During the intake session, the clinician obtains the caregiver’s phone number, address where they are located for the session, and an emergency contact. It is discussed that the caregiver will be contacted if there are any issues meeting with the child in-session. While this may include safety issues, including threats to harm self or others, it more often includes situations where the child is exhibiting difficulties engaging in treatment, including disappearing from the screen or turning off the camera. The physical address where the family is accessing the session is important in the event of an emergency where the clinician needs to direct emergency personnel to the family. In addition, it may be helpful to have an adult in the home for the duration of the child’s session. While caregiver

While the decision to receive teletherapy services can be made collaboratively with the family, there are some cases that may be better suited for in-office services. First, young children and children with significant attention difficulties and/or hyperactivity may have some difficulty engaging in teletherapy services. Oftentimes, treatment with these children includes considerable behavioral management, which is difficult to implement via teletherapy without the assistance of a caregiver in the room. These children also have short attention spans that may be better suited to several multi-sensory activities in session. While not impossible, this can sometimes be challenging to achieve with teletherapy, especially without the assistance of a caregiver in the room. In addition, cases

NJ Psychologist

Fall 2023

involvement is a central tenet of TF-CBT, this also ensures that an adult is present should there be a pressing safety issue to discuss or the need for a child to access crisis intervention services. Adolescents are also involved in these conversations as part of reviewing initial confidentiality guidelines. In addition, a central clinical consideration for teletherapy is finding creative ways to access therapy materials to increase engagement with families and enhance treatment. This has perhaps been the area where we have seen most growth over time, as clinicians become more comfortable with the teletherapy technology and more creative in applying strategies and activities typically used for in-office sessions. Presentation programs, such as Microsoft PowerPoint, allow for development of interactive games that can be tailored to any component of treatment. Our clinicians have developed PowerPoint activities to review psychoeducation, affect regulation, and safety skills, among others. Websites like YouTube and Amaze.org have many videos that can be utilized to review a multitude of skills or to review therapeutic stories. In addition, any of the handouts that were used in office to provide psychoeducation on various topics and review parenting skills were converted to electronic documents that could be shared with clients. The trauma narrative is the component of TF-CBT that facilitates increased exposure to, and cognitive processing of, a traumatic event. Children can choose how they want to create their narrative, with popular options including dictating to the therapist and drawing pictures while adding narration. While there are many ways to successfully facilitate a trauma narrative, our clinicians have found various creative ways to engage children around the narrative work using teletherapy. For example, children can dictate their narrative to clinicians as the clinician types into a word processing program. A presentation program can also be used to type a child’s dictation while easily including images and/or other ways to personalize, such as different colors or slide patterns. Clinicians have utilized the paint application for children to draw parts of their narrative. In addition, for younger children or children who benefit from drawing pictures as part of their narrative, clinicians have asked caregivers to provide their child with paper and coloring tools to draw pictures in session. At the end of the session, the child or caregiver can hold the picture up to the camera to allow the clinician to take a screenshot of the drawing. It is important to have conversations with the caregiver and child (if age appropriate) about the importance of keeping such drawings safe and/or disposing of the drawings when clinically appropriate.

Through the COVID-19 pandemic, we at the CARES Institute have found teletherapy to be a valuable tool for delivering trauma-focused therapy for children and families. It is effective and can be successfully used to deliver evidence-based practices with fidelity. Furthermore, teletherapy increases access to treatment for many motivated families who might otherwise experience difficulty engaging in or completing treatment due to external barriers. We are pleased to continue to offer teletherapy as an option for mental health services. About the Authors Kristine Hodshon, PsyD is a licensed psychologist at the CARES Institute at Rowan-Virtua School of Osteopathic Medicine. She specializes in the evaluation and treatment of children who have experienced abuse or trauma, as well as provides supervision to postdoctoral psychology fellows. Elizabeth McIntyre, PhD, is a licensed psychologist at the CARES Institute at Rowan-Virtua School of Osteopathic Medicine. She specializes in the evaluation and treatment of children who have experienced abuse or trauma. References Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2016). Treating trauma and traumatic grief in children and adolescents, 2nd Edition. Guilford Press. Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Heflin, A. H. (2015). Child sexual abuse: A primer for treating children, adolescents, and their nonoffending parents, 2nd Edition. Oxford University Press. Hanson, R. F., Moreland, A. D., & Orengo-Aguayo, R. E. (2018). Treatment of trauma in children and adolescents. In APA handbook of psychopathology: Child and adolescent psychopathology, Vol. 2 (pp. 511-534). American Psychological Association. Jones, A.M., Shealy, K.M., Reid-Quiñones, K., Moreland, A.D., Davidson, T.M., López, C.M., Barr, S.C., & de Arellano, M.A. (2014). Guidelines for establishing a telemental health program to provide evidence-based therapy for trauma-exposed children and families. Psychological Services, 11(4), 398-409. doi:10.1037/a0034963 Stewart, R.W., Orengo-Aguayo, R.E., Cohen, J.A., Mannarino. A.P., & de Arellano, M.A. (2017). A pilot study of trauma-focused cognitive-behavioral therapy delivered via telehealth technology. Child Maltreatment, 22(4), 324-333. doi: 10.1177/1077559517725403 Stewart, R.W., Orengo-Aguayo, R.E., Young, J., Wallace, M.M., Cohen, J.A., Mannarino. A.P., & de Arellano, M.A. (2020). Journal of Psychotherapy Integration, 30(2), 274-289. doi: 10.1037/int0000225

NJ Psychologist

Fall 2023

NJPA Foundation Community Service Program Grants

By Mathias Hagovsky, PhD President, NJPA Foundation

A fundamental component of our Foundation’s mission is to support the training of graduate students. One way we meet this goal is by providing funding for student-initiated research and projects addressing psychological issues that have significant impact on community health. Through the generosity of individual contributions, we are able to offer four awards and scholarships for innovative family, school, and community projects: The John M. Lagos Award for Research Into Causes and/or Treatment of Social Problems; The Dr. Zellig Bach Award for the Study of the Family; The NJPA Foundation Scholarship for Research on Diversity Issues; The Winifred Starbuck Scott Award. Read more about these awards here. In addition to supporting the New Jersey Psychological Association (NJPA) mission, the mission of the Foundation promotes the psychological health of the diverse people of New Jersey. Funds are used to support training sites and graduate students through grants and awards in support of our commitment to diversity, public health, and assisting our most vulnerable community members. Learn more about the NJPA Foundation here! The NJPA Foundation is able to continue its mission because of your support and generosity. By contributing you'll help ensure that this important work continues. Donate Today! The John M. Lagos Award for Research Into Causes and/or Treatment of Social Problems ($2,000): Awarded for the study of causes and/or treatment of social problems. Some possible topics include school issues, work problems, health issues, and aggression.

2023 Winner: Valerie Wong Development and Validation of the Positive Rumination in Disordered Eating Questionnaire The NJPA Foundation Scholarship for Research on Diversity Issues ($2,000): Awarded to a graduate student in psychology who advances the following goals: (a) promote scientific understanding of the role of diversity in psychology; (b) foster the development of sensitive models for delivery of psychological services to diverse populations. Some possible topics include issues related to cultural or ethnic issues, socioeconomic issues, gender issues, or work with underserved populations. 2023 Winner: Qingqing Yin DBT Skills Video Intervention for Chinese/Chinese American College Students

NJ Psychologist

Fall 2023

Welcome New Members! Licensed 5+ years

1st year Post-Doctoral

Carolyn AlRoy, PsyD Asimena Charalambidis, PsyD Linda Cifelli, PhD Therese Cresanti-Daknis, PhD Francis Guenther, PhD

Samantha Defilippo, PsyD Caitlin Ferrer, PhD Andrew Lima, PsyD

Licensed 2 - 5 years

Lucy Wood, PhD

Tiffany Channing, PsyD Alexandra DeGeorge, PsyD

Non-Resident

Licensed < 2 years

Non-licensed Doctoral

Claire Shindler, PhD Rob Wolf, PhD

Mike Filiaci, PhD Jenifer Levy, PhD Elizabeth Ryan, PhD

Graduate Students Alisha Akins Yeasmin Ali Austin Blakeslee Kim Boxer Elaine De Julio Amy German Gabrielle Gunin Mikayla Haas Manisha Janjikhel Kseniya Katsman Abigail Koller Cornelia Marian Isabelle Nicholas Roshni Patel Jacqueline Prairie Samantha Silverberg R. Rhiannon Simons Shira Wolff

NJ Psychologist

Fall 2023

Telemental Health for Individuals Incarcerated: Connecting Clients in Carceral Settings

Blanca N. Garcia, MA

Elisha A. Beinart, LMSW

David Brandwein, PsyD

COVID-19 magnified the social inequalities of the impact of trauma. The accessibility to basic needs, physical health, and mental/emotional health reinforced individual and communal threats to stability and continuity of selfhood. The pandemic sparked a reexamination of how to expand the reach of healthcare services, resulting in the normalization and popularity of telehealth practices.

there were approximately 1,200,000 individuals incarcerated in state and federal prisons (Carson, 2022). Due to the rapid spread of the coronavirus in prisons and systemic severe issues, living quarters of prisons and jails exposed a critical example of the injustices to vulnerable populations and the social disparities (Kothari et al., 2020). Older adults accounted for the majority of state prison populations because of decades of extreme sentencing. The prisons held limited access to quality medical services, contributing to the health crises, leading to older adults experiencing more chronic health conditions and increasing the risk of severe complications from the coronavirus because of social distancing limitations (Urell, 2022). There were efforts and actions toward the early release of some of the most vulnerable individuals incarcerated, including the elderly. Twenty-four states released approximately 37,700 individuals earlier than their scheduled release date, hoping to lower the Covid-19 spread (Carson et. al, 2022). Staff decreased when employees were in quarantine, and according to BJS August special report, approximately 196 correctional staff members in state and federal prisons died due to Covid-19 (2022). This decrease in correctional staffing within prisons during Covid-19 contributed to inadequate protection from violence and abuse for those in carceral settings.

The Carceral Setting Families and individuals retreated to their homes for shelter to maintain health and safety during the height of the pandemic. Many people incarcerated, facing the same fear and uncertainty, remained incarcerated. Close to 11 million individuals are detained in correctional settings worldwide, with approximately 2 million incarcerated in the United States (Fair & Walmsley, 2021). Incarcerated individuals were infected by the coronavirus at a much faster rate, five times higher, than the United States general population, as reported by the Journal of the American Medical Association (Urell, 2022). In an already challenging environment, there was limited access to healthcare, personal protective equipment (PPE), and hygiene products in carceral settings, leaving many susceptible to Covid. Over 374,000 individuals were testing positive for Covid and "1.5 Covid-19 related deaths per 1,000 inmates" in state and federal prisons (Carson et al., 2022; Carson, 2022). These deaths and early release contributed to the 1% decrease in the prison population. At the end of 2021,

The carceral population comprises individuals with greater rates of mental illness (Fazel & Seewalk, 2012).

NJ Psychologist

Fall 2023

access to mental health services tailored to each individual's needs and support for their families and communities.

American prisons and jails incarcerate a disproportionate number of individuals impacted by current or past mental health issues. In a 2016 survey among people incarcerated in federal and state prisons, 41% reported a history of mental illness, including the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, post-traumatic stress disorder, personality disorder, and schizophrenia/other psychotic disorders (Maruschak et al., 2021). The carceral environment can be innately damaging to one's mental health leading to a theorized Post-Incarceration Syndrome (PICS), a psychiatric disorder affecting those who have a history of incarceration and are released back into the society (National Incarceration Association, 2023). PICS encompasses three components: 1) the effects of traumatic experiences suffered during incarceration; 2) the evidence of lived trauma that influences desperate living decisions; and 3) the extended traumatic triggers connected with imprisonment (National Incarceration Association, 2023). Psychological, social, and emotional difficulties are often enhanced when assimilating into the community, risking the onset and inflation of mental health symptoms, including institutionalized personality traits, social-sensory disorientation, and social and temporal alienation (Prison Policy Initiative, 2021). In current research gathered by the Prison Policy Initiative, one in four people in jails experiences "serious psychological distress." The number of these individuals receiving mental health treatment is scarce. Approximately 66% of people in federal prisons and 74% in state prisons reported not receiving mental health care while incarcerated (Prison Policy Initiative, 2023).

To address the complex needs of incarcerated individuals, it is important to recognize the importance of early intervention and prevention. This includes investing in mental health services and programs designed to address the underlying causes of criminal behavior, such as poverty, trauma, and substance abuse. By taking a more comprehensive approach to mental health care in the criminal justice system, we can help to reduce the likelihood of institutionalization and promote positive outcomes for individuals and communities. Telemental Health Although present in psychotherapy for a few years, telemental health services were promoted worldwide during the pandemic as a solution to address barriers to therapeutic treatment through telecommunication technologies. For many, the pandemic was an unprecedented, life-altering experience that caused isolation, elevated uncertainty, and fear. Telemental health became a safe way to receive help for immediate emotional needs. It was popularized during Covid-19 because of the accessibility to provide treatment for anticipated long-term mental health needs in response to the global trauma (Zangani et al., 2022). Those incarcerated experienced a sudden extreme change of lifestyle as well, adapting to isolation, changes in autonomy, freedom, position in society, and perception from others with overcrowded conditions.

The process of exiting the prison system does not simply involve the removal of a khaki jumpsuit. Rather, it is a complex experience that is compounded by the trauma and mental illness that individuals may have experienced prior to their involvement with the criminal justice system. Institutionalization is a multifaceted phenomenon shaped by various factors, including the provision of mental health services.

Overcrowding is a significant contributing factor to the high incidence of mental health problems in prisons globally, in which the prevalence of mental health resources is limited, and in the United States, this is further magnified because of the overpopulation of incarcerated individuals (Sims et al., 2021; Incarceration Nations Network). The physical and organizational environment of prisons impacts emotional suffrage. In a qualitative study, individuals incarcerated reported that extended periods of isolation with minimal mental stimulus contributed to poor mental health (Nurse et al., 2003). They expressed experiencing intense feelings of anger, frustration, and anxiety relating to the environmental confinement of

The available data suggest that there have been missed opportunities to address the mental health needs of incarcerated individuals. While crisis-based interventions may be necessary in certain situations, a more comprehensive approach is needed that prioritizes long-term care and support for growth. This includes

NJ Psychologist

Fall 2023

prisons. In a systematic review by Johnson et al., examining the impact of Covid-19 on the mental health of imprisoned people and prison staff, identified four key challenges negatively shaping mental health: the fear of Covid-19, social distancing and isolation, discontinuation of prison visits, and reduced/discontinued mental health services (2021). As proposed in the review’s findings, the pandemic has profoundly affected the mental health of individuals living and working in prisons. In carceral settings, the pandemic increased stress and anxiety over the risk of themselves and their loved ones contracting or dying from Covid-19 (Johnson et al., 2021). Survivor guilt and grief added to the heightened negative emotional experience of living through the pandemic within the prison walls. The restricted movement, visitation, and use of isolation to control the spread of the virus is likely to have contributed to additional distress. Johnson et al. found that “longer quarantine increases the severity of impact, and when a restriction to liberty is imposed rather than voluntary, it leads to more distress and greater longterm mental health complications” (2021). In a time of shared trauma, routine services for mental health were deprioritized or withdrawn due to infection risk (Johnson et al., 2021).

can promote a sense of safety, security, care, and support, likely scarce within staff-resident relationships to which they are accustomed. The demand for treatment in carceral settings is ever-present. The inaction of prioritizing all human mental health needs contributes to the invisible assaults endured daily by those experiencing racial and institutionalized oppression in the carceral systems. The systemic mistreatment and abuse of those trapped within it cultivate an aversive culture toward the departments and people employed by the Department of Corrections. The long history of oppression and verbal, physical, sexual, and psychological abuse have lasting scars for incarcerated individuals that irrevocably change their life trajectory. Provision of Telemental Health in Prison Settings Various states and nations are exploring the use of telemedicine/telemental health within their carceral systems (Edge et al., 2020; Fallon, 2007). Interventions in telemental health eliminate the geographical barrier to treating patients timely as symptoms arise. Transfers to multiple correctional facilities are commonplace for those incarcerated. In Louisiana, a statewide prison telemedicine program was introduced to aid in providing access to mental health/psychology and HIV/infectious disease. Findings suggest that providers found satisfaction and telemedicine as an effective method in meeting the client's needs (Glaser et al., 2010). The Kentucky Justice Community Opioid Innovation Network is implementing a hybrid method of telehealth with females incarcerated with a diagnosis of substance use/opioid use disorder, preparing them for reintegration (Staton et al., 2021).Through telemental health, the disruption is mitigated by administering a smooth transfer to a new practitioner (American Psychological Association, 2017).

Implementing telemental health services would open a path for clients to connect with clinicians outside the prison system to address the mental health needs of incarcerated individuals. Providing clinical services from therapists unaffiliated from the carceral institution could build client interest, develop a working alliance and have a greater chance of gaining the trust needed in a therapeutic alliance. Incarcerated individuals are more likely to critically assess staff who provide mental health services because of their relation to the carceral system. In a qualitative study, Jacob & Giordano (2017) addressed the perspective of jail mental health care from incarcerated individuals. The following is a narrative of one of the participants describing his perspective on the duality of the role of a therapist that is perceived to be detrimental. “[Clinicians] have a different program and agenda and everything, but their attitude and demeanor changes. When a new [clinician] starts working, people [say], ‘Oh, we have a new [clinician]. They’re cool.’ And then in a few months, they start taking on the ways [of the jail]; there comes the separation where it’s no longer the human family, and it’s us versus them.” (Jacobs & Giordano, 2017). Therapists outside of carceral settings

Potential Benefits The benefits of using and normalizing virtual therapy in prisons are numerous. It should be emphasized that teletherapy does not impede upon the establishment of the therapeutic alliance. Studies have shown that the therapeutic alliance established in virtual psychotherapy does not substantially differ from that of in-person treatment (Batastini et al., 2021). The utilization of telemental health has substantial potential to foster positive change from a health justice lens.

NJ Psychologist

Fall 2023

Psychotherapy is a collaborative approach, grounded in dialogue, based on the relationship between an individual and their clinician to work towards selfgrowth and well-being. The client-therapist relationship in such a manner can provide consistency and stability, serving as a guide to co-construct healthy relationships outside of the therapeutic framework. Such work can foster the support of familial and social relations, which can support lower rates of recidivism and help inmates forge a healthier path forward.

services contribute to economic hardship. As reported in February of 2023, there is a shift with the federal government in allowing states to allocate Medicaid funds to treat people incarcerated for drug addiction and mental health services (Murez, 2023). During a visit to the Camden County Jail in New Jersey, Dr. Rahul Gupta, the director of the White House Office of National Drug Control Policy, encouraged states to submit proposals for their intended use of Medicaid funds. The government confirmed the inclusion of mental health and drug treatment to be offered as part of permitting Medicaid funds in jails and prisons with the hopes of removing economic hardships from being the barrier to receiving therapeutic and drug treatment services. (The White House, 2023). In this way, the federal government is making steps towards making mental health and treatment affordable for programs such as telemental therapy for immediate and lasting positive growth.

Ethical, Legal, and Clinical Considerations The provision of telemental health services requires practitioners to adhere to ethical, legal, and clinical guidelines. It is important for psychologists and related mental health practitioners to uphold their profession's code of ethics and possess both technological and clinical competence (Barnett & Kolmes, 2016). To ensure the privacy of clients, HIPAA-compliant platforms that meet federal requirements must be used. However, providing technology devices and reliable internet connection in prison can be challenging, and disruptions or emergencies may occur during the session. Therefore, practitioners must develop a plan to address these issues. Obtaining informed consent from clients and notifying them of privacy limitations are imperative. In addition, screening clients for appropriateness of telemental health services is crucial, taking into account factors specific to this population, such as around-theclock supervision, residence within a controlled environment, and behaviors atypical of the general population. The practitioner must also possess cultural, ethnic, and linguistic competency to respect clients' beliefs and practices. In case of a crisis, the psychologist must be aware of resources available within the prison environment and able to refer the client to needed resources that are appropriate and accessible to the inmate. Overall, adherence to ethical, legal, and clinical guidelines, along with thoughtful consideration of specific factors related to this population, is necessary for providing effective telemental health services in prisons.

Conclusion The proposal of connecting incarcerated individuals with therapists in the community through technology is an approach to combat social and racial disparities by advancing the accessibility and affordability of mental health services. The post-pandemic era necessitates an immediate and ongoing change to bring human health rights to all. There is a responsibility to improve the carceral culture. The application of telemental health treatment within prison settings can change the trajectory of lives on the inside and out. References Furnished Upon Request About the Authors Blanca Garcia is a doctoral candidate at Kean University in the Combined School and Clinical Psychology, PsyD program. She received a master’s in forensic psychology from John Jay College of Criminal Justice. Elisha Beinart is a licensed social worker employed at Kennedy Counseling and studies at the William Alanson White Institute for psychoanalysis. Previously she worked with formerly incarcerated individuals during the Covid-19 pandemic. Dr. David Brandwein is an associate professor at Kean University. He is also the Department Chair of the Department of

Financial Opportunity

Advanced Studies in Psychology, which houses the Professional Diploma in School Psychology and the Doctoral Program (PsyD)

Financial strain arises for those who are incarcerated as a result of having to support both their own needs and those of family/friends in the community. Therapy may not be affordable nor a priority to an individual if the

in Combined School-Clinical Psychology. Dr. Brandwein also maintains a private practice in Monmouth County, New Jersey and specializes in forensic evaluations in civil and criminal matters.

NJ Psychologist

Fall 2023

Commentary

Thirty-Five Years as a Forensic Psychologist: A Retrospective

By Matthew Barry Johnson, PhD This article is reprinted with permission by the American College of Forensic Psychology. The original article can be found in Volume 40, Issue 4 of the American Journal of Forensic Psychology.

The author reflects on his 35 years as a forensic psychologist, noting the psychologists who personally helped in his career.(1) He also cites the psychologists whose research he drew from in formulating his own perspectives. He points out that forensic psychology involves not only reliable testimony consistent with

Dr. George Jackson, a founding member of the Association of Black Psychologists. Dr. Jackson was well known in my community, and I understood he made court appearances related to his work.

prevailing law, but also psychological input that can alter the law. He describes his contributions in three areas: parental rights termination, challenging the death penalty, and wrongful conviction.

My interest in forensic psychology was evident as I began graduate studies in psychology in the late 1970s. As an undergraduate, I did not study psychology. I had seriously considered law as a profession. I am not going to talk about my early life, my coming of age, or how I came to psychology, other than to note that I became a psychologist principally to be a forensic psychologist.

By the time I completed my doctoral coursework in the early 1980s, my knowledge of forensic psychology was still rather limited. In order to become a valued expert witness, I wanted to provide thorough and reliable psychological findings for the courts that were informed by a working knowledge of prevailing law. Beyond that, I was aware that psychologists could, and had, made contributions not only within the confines of the law, but also to the law, by presenting psychological research and perspectives that influenced and shaped law. Foremost was my knowledge of Dr. Kenneth Clarke’s contributions. Similarly, Dr. Lenore Walker’s research and advocacy articulating the genderbiased assumptions embedded in US self-defense law had a profound impact on legal formulations and systems. Further, during the time I was entering the field of forensic psychology, I was drawn to the work of Grisso, Gudjonsson, Kassin, and Leo who were, in various ways, critiquing what the US Supreme Court in Miranda v. Arizona referred to as “modern psychological interrogation.”

My sense of forensic psychology was derived largely from references to African-American, social psychologist, Dr. Kenneth Clarke’s work cited in the US Supreme Court’s landmark Brown v. Board of Education ruling.(2) However, more proximally, the psychologist I knew personally was

I approached the field of forensic psychology with some degree of knowledge of the different perspectives and contributions. I was not interested in forensic psychology that deals with psychological disturbances that manifest in criminal behavior, which is the interest of a large portion

I have been a forensic psychologist for 35 years. Forensic psychology has been a key feature of my professional identity. I welcome this opportunity to reflect on my work as a forensic psychologist, noting my accomplishments and the challenges I have faced. In the process of this work, I developed a particular perspective and approach to forensic psychology that I have applied in my work.

NJ Psychologist

Fall 2023

Parental Rights Termination

of my undergraduate students. My interest was more in how the criminal justice and legal systems have flaws and are frequently systemically flawed.

In the late 1980s I began to consult at the Rutgers-Newark Law School, Urban Legal Clinic, and the Women’s Rights Litigation Clinic.

New Jersey, in the 1980s, was a great place to learn and become initiated into forensic psychology practice. There were several New Jersey psychologists who were pivotal in my professional development. While earning a Master’s Degree in Educational Psychology at Montclair State College in 1980, I completed two courses with Frank Dyer, former senior research associate with the Psychological Corporation. The coursework provided a strong foundation in psychometrics, relevant to both cognitive and personality assessment. Dr. Dyer became a leading forensic expert in the clinical presentation of lead poisoning in children and also psychological consultation in parental rights termination. He provided recommendations to support my doctoral program applications and I was admitted to Adelphi University, Clinical Psychology PhD Program, in the Fall of 1980. Following my coursework at Adelphi, I began a clinical internship at the Veterans Administration (VA) Medical Center in East Orange, New Jersey. At the VA, I received clinical training in the Violence Clinic from Louis B. Schlesinger, noted expert in interpersonal violence and criminal psychopathology. From Dr. Schlesinger, I learned the fundamentals of forensic consultation and expert witness testimony, which allowed me to credibly present myself as a forensic psychologist early in my career. After earning my PhD, and prior to becoming licensed, I worked part-time conducting psychological evaluations at the New Jersey Rahway State Prison.(3)

A group of lawyers were looking for a forensic psychologist who would collaborate in challenging what they considered to be arbitrary discretion on the part of the state child protective agency (known by the acronym “DYFS” at the time). Adverse racial bias in child protection decision-making was, and continues to be, a major concern. I conducted evaluations for the law clinics and began a critical review of the state statutory and case law surrounding parental rights termination proceedings. I began to formulate a comprehensive critique of “psychological parent theory,” the prevailing framework used by the courts (as well as psychologists) in contested parental rights termination. While the Rutgers Legal Clinic lawyers were looking for the right test case, I was retained by Hudson County Legal Services to examine a young Latina seeking to further appeal a trial court severing her ties to her three children. The young mother was represented by a pair of capable and diligent young attorneys who had prevailed in appellate court by arguing the trial termination decision was a product of unreliable testimony about the children’s bonding to the proposed adoptive parents. The appellate court ordered a new round of bonding examinations of the children, the mother, and the proposed adoptive parents. I conducted these examinations and testified that the older two children evidenced strong attachment to their mother

After becoming licensed in 1986, I became active in the New Jersey Psychological Association (NJPA) Forensic Committee. Here, in the early 1990s, I joined Dr. Dyer and Dr. Schlesinger, as well as other notable forensic psychologists, Phil Witt, Susan Esquilin, and Jim Wulach, as we conferred and debated major issues in forensic psychology. I was the only African-American member of the committee and perhaps also the youngest member. It was a very exciting period and I learned a great deal.

rather than the proposed adoptive parents. We did not find the youngest child had an attachment to his mother and she surrendered him to the child protective agency. However, the trial court again terminated the mother’s parental rights, as did the appellate court, upon second review. However, in a unanimous decision, the New Jersey Supreme Court cited my testimony and critique of psychological parent theory, and reversed the termination order.

When Phil Witt was elected president of NJPA in 1994, I was appointed chair of the Forensic Committee. Dr. Esquilin and Dr. Dyer began to invite me to make presentations at professional meetings. Somewhat later, Dr. Wulach began recruiting me for the psychology faculty at John Jay College of Criminal Justice, CUNY.

This case, as well as others, was presented in a law review I authored titled, Examining Risks to Children in Parental Rights Termination Proceedings. The law review was later cited as authoritative in the subsequent New Jersey Supreme Court decision In Re the Guardianship of KHO.

NJ Psychologist

Fall 2023

campaign and agenda. Toward the end of our meeting, we began to talk about who would carry out the executions and how, specifically, the condemned death row inmate would be put to death. At that time, there was one man on New Jersey’s death row who was about to exhaust his

My expert witness work and advocacy for families entangled in the child protective system was described in Dorothy Roberts’s Shattered Bonds: The Color of Child Welfare. Much of my critique of psychological parent theory has been embraced in recent New Jersey statutes; for example, my “Examining Risks…” law review stated, “[psychological parent] theory does not appreciate the myriad of caretaking relationships a child can enjoy. Children exhibit behaviors indicating attachment and bonding in relation to their siblings, peers, father, and other

appeals. The senator’s expressed support for the death penalty seemed to waver as we contemplated the details of the government’s taking of human life. This led me to research the topic of secondary trauma from state executions and formed the basis of subsequent testimony and scholarship. Adcock and others have further elaborated research in the area of secondary trauma from

adult caretakers, as well as their mother” (p. 407). The declarations that precede the 7/02/21 New Jersey Legislature amendments to the child protection statute include, “Children are capable of forming healthy attachments with multiple caring adults throughout the course of their childhood, including with birth parents, temporary resource parents, extended family members, and other caring adults.”(5)

state executions. In 2007, the senator we met with, along with a majority of his colleagues, voted to abolish the New Jersey death penalty. Governor Corzine signed the legislation. Following the example of the New Jersey legislature, several state legislatures thereafter abolished capital punishment (New Mexico in 2009, Illinois in 2011, Connecticut in 2012,

Challenging the Death Penalty

Maryland in 2013, Delaware in 2016, and Virginia in 2021). Ten years after the New Jersey abolition, the New Jersey

In the early 2000s, I became involved in the campaign to abolish the death penalty in New Jersey. My decision reflected my personal values and vision, but was also informed by the APA Death Penalty Resolution, which cited relevant research challenging the use of state executions. I joined New Jerseyans for a Death Penalty Moratorium, which later evolved into New Jerseyans for Alternatives to the Death Penalty (NJADP), and I was subsequently appointed to the Executive Board. I enlisted the support of both the New Jersey Chapter of the Association of Black Psychologists (NJABPsi) and NJPA in the campaign against state executions. I also represented the Peoples’ Organization for Progress on the NJADP Board and coordinated strategy with James Harris, State president of the NAACP. This work included community education, legislative lobbying, and research. In 2003, I began serving on the American Bar Association Task Force on Mental Disability and the Death Penalty.

Law Journal celebrated the event noting the positive consequences without an increase in murders.(7) I learned a great deal about legislative lobbying, press messaging, and coalition work during my tenure with the NJADP. Two people from the New Jersey campaign to abolish the death penalty had a special impact on my work. David Shepherd and the late Nate Walker were two New Jersey exonerees who also served on the NJADP Board. Both were African-American men who had been wrongfully convicted of sexual attacks on white victims associated with crossracial misidentification. Both had served lengthy periods in state prison prior to exoneration. Their ordeal dramatically illustrated error in the criminal justice and judicial systems, and thus their stories were invaluable sources as we advanced our challenge to state executions. In addition, these two men personally introduced me to wrongful conviction stemming from eyewitness misidentification. During this period, Professor Gudjonsson stated in his book, The Psychology of Interrogations and Confessions, that eyewitness

Amanda Gil, Ingrid Johnson, and I published a law review summary of my 2005 testimony before the New Jersey Department of Corrections.(6) We focused on secondary trauma from state executions to shift the debate from whether the convicted deserved to be put to death to the (adverse) effects of a state execution. This research was a by-product of our legislative efforts. I was a member of an NJADP delegation that met with a New Jersey State Senator (a lawyer) who informed us he supported the death penalty for those people who had committed heinous crimes; however, he was willing to meet with us to discuss our

misidentification was a larger contributor to wrongful conviction than false confessions. Wrongful Conviction My interest in wrongful conviction originally stemmed from an interest in false confessions and police abuse. It was my impression confessions were supposed to be

NJ Psychologist

Fall 2023

voluntary and it seemed that no one would voluntarily submit to interrogation. A pivotal experience was viewing A Death in Canaan, the film dramatization of the Peter Reilly false confession. Early in my career as a forensic psychologist, I began to review the literature and research related to interrogation, Miranda rights and the Miranda waiver process. As a result of the application of DNA to criminal investigation through the 1990s, the issue of wrongful criminal conviction became an undeniable aspect of the US criminal justice system. Recognizing the risk of

For 35 years I have enjoyed a rewarding career as a forensic psychologist, striving to be an advocate for justice, and contributing to the education of my students. Yet, so much more still needs to be done. As I drew from the work done by forensic psychologists who preceded me, I have had the good fortune to engage with many young psychologists in the field who will continue this work when I retire. Notes

wrongful conviction stemming from false confession, I authored law reviews, a case report, and letters in the New Jersey Law Journal advocating mandated recording of the entire period of custodial questioning. This policy was adopted by the State of New Jersey with implementation in 2007.(8)

1.This is an expanded version of remarks delivered by the author upon receipt of the New Jersey Psychological Association, Lifetime Achievement Award (10/21/22). 2.The effects of segregation and the consequences of desegregation: a social science statement in the Brown v Board of Education of Topeka Supreme Court case. American Psychologist 2004; 59:6:495- 501 3. Later renamed East Jersey State Prison 4. I was ably assisted by GSAPP graduate, Luis Torres. 5. See note here 6. I also later testified before the New Jersey Legislative Death Penalty Study Commission, 7/19/06. In 2012, I coauthored, with Dr. Daniel Williams, the (National) Association of Black Psychologists Death Penalty Abolition Resolution. 7. https://deathpenaltyinfo.org/news/new-jerseymarks-tenth- anniversary-of-abolition-of-capitalpunishment 8.New Jersey Attorney General Directive on Recordation of Custodial Interrogations.

As a result of what I learned from David Shepherd and Nate Walker, and also informed by the 2002 exoneration of the Central Park Five defendants, Shakina Griffith, Carlene Barnaby, and I authored a research paper on Black defendants wrongly convicted of sexual assaults against whites.” These findings were presented at the 2012 Academy of Criminal Justice Sciences meeting and led to further research and ultimately the book, Wrongful Conviction in Sexual Assault: Stranger Rape, Acquaintance Rape, and Intrafamilial Child Sexual Assaults. The book catalogued the prevalence of sexual assault among confirmed wrongful convictions, differentiated the investigative challenges associated with stranger rape, underlined the increased risk of wrongful conviction faced by Black defendants, and presented new directions for wrongful conviction research. My research group also applied the offense specific risks of wrongful conviction to the prosecution of shaken baby syndrome/abusive head trauma by outlining direction for psychological consultation in this area. Also, I applied my accumulating expertise regarding wrongful conviction to advocacy on the behalf of Lawrence Wright, which led to his release following five years of pretrial detention at the notorious Rikers Island jail in New York City.

Acknowledgements The author is thankful to Christine Baker, PhD and Maat E. Lewis, PhD for providing feedback on early drafts of this paper. The author is grateful to Abisola Gallagher, EdD, Luciene “Lucy” Sant'Anna Takagi, PsyD, and Kimberly Echevarria for nominating him for the New Jersey Psychological Association, Lifetime Achievement Award. References Furnished Upon Request About the Author

Conclusion

Matthew Barry Johnson is a Professor of Psychology at John Jay College of Criminal Justice, CUNY. His areas of focus are interrogation, false confession, wrongful conviction, and racial bias. He recently authored Wrongful Conviction in Sexual Assault: Stranger Rape, Acquaintance Rape, and Intra-Familial Child Sexual Assault (Oxford University Press, 2021). Professor Johnson was the recipient of the Lifetime Achievement Award from the New Jersey Psychological Association in 2022. Professor Johnson received the Elizabeth Hurlock Beckman Award in 2020 in recognition of inspirational mentorship.

This is the story of my journey into and through forensic psychology. Working with and learning from others, experts and laypersons alike, led to meaningful accomplishments. About 10 or 12 years ago, as I was preparing a presentation for doctoral students at John Jay College of Criminal Justice, I realized, retrospectively, that the focus of my work could be summed up as ‘how psychology informs due process.’

NJ Psychologist

Fall 2023

On Planning Your Retirement: Some Personal Suggestions

By Robert Kornhaber, PhD, Retired

Recently the NJ Psychologist reprinted Mary Blakeslee's

Closing Your Office

very useful article on strategies for retiring from a private practice. Having done so myself in late 2020 and landing on my feet, I enjoyed comparing my experience

Although it's suggested that you see your last client "at least one week before you close your office," I strongly

with the advice provided in the article. Although it correctly mapped out what to do and how to do it, I felt

recommend that you give yourself several weeks, especially if you are keeping the office intact until you

that I might take this opportunity to expand on several of its recommendations so as to help future retirees be a

stop seeing clients. The unexpected can always happen with your move. And there is also the possibility that you

little better prepared for this unique and challenging episode in their career. In other words, the process of retirement can be more complicated and time

may need (or want) to see one or more clients for an additional session or two to ease the transition for them. You never know until you get to that time. As was said to

consuming than we would like.

me by a wise attorney as my date for retirement approached, "You may be ready to retire but that doesn't mean your patients are ready for it."

The New (and Former) Client Dilemma As you approach the last year of your practice, the issue of taking on new clients, even for some short-term treatment, is a tricky challenge. This is especially true if in the past you were always willing to fill in that empty slot in your schedule. And although that new caller has assured you that they only need "a little help" or "have only a minor problem," try not to fall for it. You know from years of experience that their issues are going to be a lot more complicated. And, even when it is a former client that you loved working with, it is still best to refer them. Planning your retirement is going to be enough stress.

Terminating Your License If you are planning to renew your professional license (and maybe your malpractice insurance), feel free to skip this section. But, if you will not be renewing your license, then I strongly recommend that you retire at least a few months before it expires. That allows you to sleep better if the process of terminating your patients drags on for any unforeseen reasons. Let's not forget that, thanks to teletherapy, patients can reach out to you long after your office door is closed. And, if you feel the need to address their issues, being licensed and insured will be good for your mental and professional health.

NJ Psychologist

Fall 2023

Lining Up Referrals

again, start out as early as possible and keep working at it. It can be a bumpy road.

It is important that clients who need to continue seeking treatment have appropriate referrals from you. With this in mind it is recommended that you give them several names well before they leave your care. In a nutshell, that suggestion is easier said than done. For all the reasons given below, I would start at least four months before your retirement. (Even when you have recommended new therapists, some clients may want to

Dealing With Rentals (And Other Office Arrangements) Retirement meant ending my practice in two locations: one at an office condo I owned, the other an office space I shared with several other therapists. Although office condos are not that common, if you own one and want to sell it when you retire, be prepared for an arduous and challenging experience. As a medical doctor had warned me, they are not easy to sell since most health professionals tend to rent and have no interest in buying a property. Although my condo offered me decades of worry-free space, it was not easy to find a buyer. Despite my efforts and that of my realtor, I got only one offer and that required a significant price drop. (At that point I was just happy to sell it.)

meet with them before you retire so they can talk over the experience with you.) Let's begin with the (almost) obvious problem of referring to associates; as I got older, the mental health professionals I knew personally also aged. So when I planned my retirement at 74, a few had already retired, others were planning their own retirement, and some were no longer taking on new clients. Although a few were willing to accept one or two new cases, that left me seeking referrals for the remaining clients in my

uncomfortable with the process or hoped I could find them an appropriate therapist who was familiar with their particular issues. Although I was willing to devote

Although a rental space does not need to be sold, if you don't have an easy going landlord or an escape clause that allows you to leave with 30-60 days notice, coordinating your departure with the expiration of your lease is essential. And if you share your space with other therapists, advance planning is necessary so they don't feel mistreated. So again, plan for this well in advance and don't spring your departure on your landlord or associates.

some of my free time to this goal (I no longer had a fulltime practice), it was challenging. And when I spoke with

A Departing Word

therapists who were accepting new patients, there were still obstacles to a smooth transition: Did the therapist accept my patient's insurance? Was the therapist's orientation compatible with my approach? Did the therapist work with my client's mental health problems? And could my patient reach their office in the event telehealth ended? (I worked with several agoraphobics.)

Fortunately psychologists are good planners and NJPA offers plenty of advice on retirement. Keep reading up on it and consult with your colleagues (and others professionals) when necessary. And, of course, start early.

practice. Even though NJPA's referral program is very useful and not hard to navigate, some clients were either

About the Author

Although I was comfortable with the results of my efforts (and thankfully most psychologists returned my calls), it took a lot more time than expected. This was especially true for the few patients who, for various reasons, needed to be referred to a community mental health center. Finding a contact at a facility and convincing them that my client could not wait four or five months for a first appointment was challenging. So

Robert Kornhaber is a retired clinical psychologist. After completing a post-doctoral fellowship in 1975 at Albert Ellis' Institute for Rational Emotive Therapy (now the Albert Ellis Institute), he began a private practice lasting 45 years. Employing cognitive-behavior therapy, he specialized in the treatment of agoraphobia and other phobic disorders. To help patients overcome fears he employed various in vivo desensitization strategies and when necessary provided home treatment.

NJ Psychologist

Fall 2023

APA Council of Representatives Report

By Rhonda Allen, PhD Council of Representatives (NJ) (2019-24)

The Council of Representatives of the American Psychological Association of Representatives held a hybrid meeting, with most Council members convening in person in Washington, DC, on August 2-3, 2023.

and children of alumni; targeting students at high schools that have a limited history of sending applicants to their school; paying full tuition in geographic areas for students with family incomes of $150,000 or less; establishing early college programs that allow high school students to take courses to earn college credit; and providing academic support and college admissions advice to high school students in low-income communities.

The following is a summary of the major decisions and votes at this meeting. Some of what is reported below is excerpted from a meeting summary provided to council members from APA. Need for Safe Work Environments for Adolescents

Mental Health Screening and Practice of Law

The Council adopted a Resolution on Developmental Risks and Opportunities in Adolescent Employment, urging employers to establish safe working environments and work hours for adolescent employees in the wake of recent reports of youth being injured or killed due to unsafe job conditions. The resolution passed 161-2, with 2 abstentions. The resolution also asks the field of psychology and policymakers to support increased research, monitoring, intervention, advocacy and policy to inform and guide safe labor practices for adolescents.

The Council adopted a policy opposing the use of mental health screening questions on character and fitness exams for licensure to practice law. “Statistical data reveal that there is no connection between bar application questions about mental health and attorney misconduct and that such questions have not been empirically shown to work as a successful screening tool for who can and cannot practice law in a competent manner,” the resolution states. The policy pledges that APA will work with the American Bar Association and state bar associations to remove questions regarding mental health diagnoses or treatment history from character and fitness questionnaires.

Equity and Inclusion in Student Admissions in Higher Education In the wake of the US Supreme Court’s ruling outlawing the consideration of race as a factor in college and university admissions, the Council adopted a policy statement reaffirming its support for equity and inclusion in higher education. The vote was 142-6 with 8 abstentions. The resolution called for measures including “adversity scales” where colleges consider the adversity a student has overcome when selecting among qualified applicants, The resolution also called for eliminating preferences for the wealthy, such as donors

BEA Racial Disparities Task Force Report on Racism and Bias and Racial Disparities in PreK-12 Education The Council voted 143-19 with 1 abstention to receive the report of the Board of Educational Affairs Racial Disparities Task Force, with the future addition of a foreword outlining the context and limitations of the report. The report looks at racism and bias and their role in creating educational disparities; disparities at the intersection between race and disability; discipline

NJ Psychologist

Fall 2023

disparities and school pathways to the juvenile justice system; and racial/ethnic mismatch between the educator workforce and school-age population. It also updates recommendations for research, practice and advocacy, and contains new recommendations for educator preparation.

Psychology to the Agenda Planning Group. It voted unanimously to change the eligibility criteria for serving on the Needs Assessment, Slating and Campaigns Committee (NASCC). Changes included reducing the waiting period after serving on APA’s Board of Directors and Council prior to eligibility for NASCC from two years to one and removal of the restriction on simultaneous service between NASCC and elected positions with state/provincial/territorial associations or any divisions. •

BSA Task Force Report on Tenure and Promotion for Faculty of Color The Council voted unanimously to receive the report of the Board of Scientific Affairs Report on Tenure and Promotion for Faculty of Color. This report details systemic barriers and inequities that affect the evaluation of faculty of color under review for promotion and tenure in psychology programs. It also provides practical guidance and strategies for college and university administrators and external reviewers who will consider candidates for promotion and tenure in psychology departments with the understanding that dismantling systemic racism in psychological science has been identified as a guiding principle of APA.

Council members voted 138-11 with 2 abstentions in favor of forwarding to membership for a vote an amendment to the APA Bylaws that would change the requirement for the number of candidates to be included on the president-elect ballot from five to up to five. Council approved (143-17 with 1 abstention) amendments to Association Rule 110-14 to clarify rules prohibiting simultaneous service on the Board of Directors and other elected or appointed APA positions.

Guidelines for Operational Psychology

Council approved (120-36 with 3 abstentions) forwarding a proposed bylaw change that would require the Policy and Planning Board to formally consult and discuss with Council before proposing any amendments. The measure now goes to the full membership for a vote. I was a co-mover and the presenter for this business item. I strongly urge all APA members to vote for its passage and to also vote in all future elections and bylaws change amendments that are presented.

The Council voted 107-55 with 4 abstentions to adopt the Guidelines for Operational Psychology as APA policy, with an expiration date of Dec. 31, 2028. These guidelines provide recommendations for psychologists engaged in operational support activities within the areas of national security, national defense and public safety. The purpose of the guidelines is “to maintain and improve the quality of operational psychology services, standardize and enhance the professional delivery of such services, encourage the practice and continued development of operational psychology, and respect the applicable rights of persons affected by such services.”

Presidential Citation and Raymond D. Fowler Award APA President Thema Bryant, PhD, presented a Presidential Citation to the Committee on Women in Psychology on their 50th anniversary in recognition for the contributions to psychology. Dr. Bryant also presented the Raymond D. Fowler Award to former APA President Sandra L. Shullman, PhD

Reports Regarding the Internal Functions of Council Council voted to receive the report of the Council Leadership Team (CLT) Evaluation Task Force. Council also voted to receive the final report of the Council Effectiveness Oversight Task Force and passed the four recommendations as provided in the report.

I encourage anyone with any questions about the upcoming proposed bylaws changes that will be sent to all APA members to please contact me. I am also more than happy to discuss any other APA matters at any time.

Amendments to Association Rules Council voted 128-25 with 9 abstentions to add the chair of the Committee on Global Psychology and the chair of the Committee for the Advancement of General Applied

I look forward to representing NJPA at the next Council of Representatives meeting in February 2024 in Washington DC.

NJ Psychologist

Fall 2023

COLA Legislative Report

By Jon Bombadieri NJPA Government Affairs Agent

September 2023

I’m hearing that the Governor’s office is not 100%

Virtual Credit Card

supportive of the making it permanent, due to costs. I’ve been working with Sara to put together some ideas for advocacy and start pushing the legislature, beyond

On June 30th, the legislation passed the General Assembly by a vote of 76-0 and now goes to the Senate

Senator Gopal, on this issue.

Commerce Committee for consideration.

State Health Benefits

I have spoken with most of the members on the Committee (Bramnick, Cryan, and Johnson) and they are supportive of the legislation. I had meetings scheduled

Labor groups, on public employee health insurance, are looking to vote on a pilot program this month to implement reference-based pricing, according to a labor

with the Chair, Senator Pou, and Senator Singer in late September. We will be working with our coalition to put together letters of support, which will also request the

official.

legislation to be posted in committee in November when

particularly what a pilot program would entail, Michael

the legislature comes back.

Zanyor, the co-chair of the State Health Benefits Plan Design Committee and a labor representative, said in an interview. Reference-based pricing refers to the concept of paying health care providers a percentage of a benchmark — usually Medicare — for their services, and it has been sought by labor groups in efforts to lower costs for the public employee health plan.

Many details need to be sorted out ahead of the vote,

Telehealth As discussed, the temporary expansion of telehealth parity rates will expire on December 31, 2023. Under the law that was signed by Governor Murphy, it stated that the Department of Health must do a study to determine costs.

An agenda for the September 27th meeting is not out yet (they are generally sent to Plan Design Committee members days before the meeting occurs).

A state study intended to guide the future of telehealth reimbursements in New Jersey, which was recommended by Governor Phil Murphy in his conditional veto, is months past its statutory deadline and may come in December.

The committee is made up of six labor representatives and six representatives from the government. The two sides have been meeting for months to figure out what reference-based pricing on the plan for state and local employees would look like.

I have been discussing this issue with the sponsors of the legislation and seeing if we can have them introduce legislation when the legislature comes back, after elections, to make it permanent.

The concept is generally opposed by providers, who say that paying a percentage of a benchmark instead of

NJ Psychologist

Fall 2023

what insurers negotiate with them could leave patients stuck paying the balance of the bill. Health care providers could also stand to receive less in reimbursements if they are paid a percentage of a benchmark.

probably won’t start until November 13th and will run to about the second week of January 2024. Medicaid Rates I spoke with the Department of Human Services about our last conversation (we spoke 4 weeks ago) and noted that psychologists were receiving the wrong Medicaid rate and pointed out that DHS anticipated that this would be corrected by now (3-4 weeks). Unfortunately, our psychologists have not received these corrections.

Labor groups tried nearly a year ago to study referencebased pricing for the SHBP, although their efforts failed to get a majority vote. State Sen. Joe Vitale (DMiddlesex), the chair of the Senate Health, Human Services and Senior Citizens Committee, introduced a bill before the Legislature’s summer break, NJ S4076, to study and implement reference pricing on the SHBP and School Employees’ Health Benefits Program.

Also, I added that one of the psychologists advised us that she recently received $90 for Code 90837, when it should have been $95.

Legislative Schedule

They circled back to me with the following:

There is no meaningful legislative schedule due to legislative elections, all 120 seats (40 Senate & 80

We are still trying to get a timeline on the corrected payments.

Assembly) are up for election. Democrats currently hold a 25-15 majority in the Senate and a 46-34 advantage in the Assembly.

On the additional rate, it appears there was an error in loading the rate. It has been corrected and added to the recycle.

Election day is November 7th, Lame Duck Session

Will let you know when we have a timing estimate.

The NJPA Referral Network Become part of our in-demand network of providers: Be a part of the solution! During the pandemic, individuals seeking mental health services skyrocketed. The expansion of telehealth services enabled many individuals to access the critical services psychologists provide creating a high demand for referrals. Your unique blend of specialized services, orientations, practice area expertise, and foreign language proficiency will help us successfully assist our diverse populations, throughout NJ, who are often conducting frustrating searches for practitioners who meet their needs. We are in need especially in the southern and western part of NJ and those with foreign language proficiency in any part of the state. Are you a licensed NJPA member? Consider joining our network today! (Free for all NJPA Sustaining Members/reduced rate for newly licensed members)