ADPTC
NEWSLETTER
December 2009
Editor: Phyllis Terry
Friedman
Associate
Editors: Don Morgan, Vic
Pantesco
Web
Master: Michael Taylor
President's
Column
Erica Wise,
Ph.D.
In
her final column as president, Erica offers thoughts and feelings about self
care, modeling, and the growth of ADPTC.
What's
In A Name?
Bob Hatcher,
Ph.D.
Bob
Hatcher and Vic Pantesco offer supports, challenges, wonderings, and invitations
about the "ADPTC" name.
The
Briar Patch: Thorny
"Minor" Challenges for Directors
Getting
Stale
Vic Pantesco,
Ph.D.
Need
familiarity breed contempt?
Thoughts on the line between "veteran" and "jaded" as a Director.
Technology: Keeping Electronic Records with
Carepaths
Colleen Byrne,
Ph.D.
Colleen
tells us more about her conversion from the world of paper cuts, stocking,
stacking, paper clips, and cleanups to that of electronic record keeping. Read more about her clinic's use of
Carepaths that she described at our meeting a couple of years
ago.
Subpoenas,
Court Orders and Other Legal Oddities Mary Alice Conroy,
Ph.D.
![MCj01051880000[1]](Dec2009ADPTCnewsletter_files/image005.gif){kind=small}
What
do you do when you and your notes are subpoenaed to court? A mini-lecture on audio file by an
expert with 30 years dealing with subpoenas, court orders and other legal
oddities.
Director's
Toolbox: Improving
the Climate in Psychology Training Clinics
Phyllis
Terry Friedman, Ph.D.
You
have to look at these two practical,
salient helps for your clinic ambience.
And there is a message too.
ADPTC at
APA
Listing
of Presentations by Members
Fulbright
Specialists Program http://www.cies.org/specialists
Sean
O'Hallaron was awarded this Fulbright which funded a semester in Thailand. Click to see a picture of Sean in "leech
boots" and find out more about the program.
Cool
Little Reviews of Stuff
Don Morgan,
Psy.D.
Don
invites us into a neat world of useful, reflective, informative doo dads. It really is cool.
New
Technologies and New Ethical Dilemmas: Reading
List of Texts and Articles
Check
it out. Does this sound good:
Maheu,
M. M., Pulier, M. L., Wilhelm, F. H., McMenamin, J. P., & Brown-Connolly, N.
E. (2005). The mental health
professional and the new technologies: A handbook for practice
today.
If
yes, then look at the other six on this useful list.
ADPTC In
2010
President's
Column
Erica Wise,
Ph.D.
"If I am not for myself, who will be for me? And when I am for myself, what am 'I'? And if not now, when?" Attributed to Rabbi Hillel ~2000 years ago.
These
words almost immediately come to mind for me as I sit down to write my final
column as your president. This quote is meaningful to me at many different
levels--both personally and professionally. For each of us as training clinic
directors, it is obvious (but not always remembered!), that we must take care of
ourselves in order to be effective in our professional roles as administrators,
clinical supervisors, clinicians, teachers and researchers. A bit less obvious
is that we serve as professional role models for our graduate students. In many
programs, graduate students look to the clinic director as a primary
professional role model. When we demonstrate effective professionalism and
self-care we are setting the stage for our students to learn how to balance
multiple commitments in their own lives.
The
selected quote is also relevant to ADPTC as an organization. We have had
important discussions at conferences and on the listserv regarding how we might
best balance our own internal needs as an organization versus how active a role
we want to take in national issues that impact professional psychology education
and training. Historically, ADPTC has been primarily focused on sharing
resources among member directors. As we have taken a central role in the
national debate on how best to integrate the competency based model, concern has
at times been expressed that we may be leaning too far towards involvement in
public discourse to the detriment of providing forums and resources for our
members. Several joint meetings (with CUDCP and APPIC) may have heightened these
concerns. I would encourage us to view this as essentially a false dichotomy. A
dialectical understanding would suggest that our involvement at the national
level solidifies our role as experts in clinical training and ensures broad
academic commitment across the profession to high quality clinical training in
clinics that are administratively connected to academic doctoral programs.
Similarly, our credibility at the national level is bolstered by our expertise
as trainers. So, while balance is critical, we can't meaningfully do either one
with out the other.
Our
March 2009 meeting in Chapel Hill was an excellent chance for us to reconnect as
an organization. I hope that many of you will attend the upcoming CCTC meeting
in Orlando (please see our website at ADPTC.org for more information and
registration links). This will be an excellent chance to continue the essential
dialectic of supporting each other during the ADPTC-only programming and
increasing our voice in professional psychology education and training at the
national level.
Erica
Erica Wise at
the edge of the Daintree Rainforest in North Queensland,
Australia during a trip to visit training clinics.
What's In A Name?
Bob Hatcher, Ph.D.
This article is part of a dialogue about
our ADPTC acronym. Other acronyms
are listed below.
When
the group of 12 (or whatever the number was) met in Chicago in 1998, we took as
our key goal the strengthening of the positions and leverage of Clinic
directors, and this is a key part of what we do now too I think. I certainly
wouldn't want to lose this part of our organization's backbone. But let me talk
a bit about where the idea for the name change came from.
The
impetus for this idea was an ongoing discussion at the CCTC meeting about the
training councils. There has been general awareness that training councils grow
and mature as organizations. Many of them started, as ADPTC did, with a focus on
the needs and concerns of the leaders of the organizations, CUDCP being a prime
example. As the organizations have matured, their focus has tended to shift
towards the broader issues related to the organizations while not losing their
interest in the needs of the directors. So CUDCP has put a lot of energy into
internship issues, competency issues, and the scientist-practitioner model, as
well as serving as a forum for ongoing directors and a training ground for new
ones. APPIC has a similar model, though it was never to my knowledge focused
only on internship training directors. Many other councils now have missions
that include a strong focus on the needs of their directors but also incorporate
broader goals and issues related to their organizations (e.g., ACCTA, CCPTP,
NCSPP). Thus, these organizations have become aware of their broader roles as
representatives for key aspects of the training of psychologists. On the other
hand, some organizations have not advanced much in this regard, either because
they are very new, or because they never got off the ground organizationally.
They tend to stand out at the CCTC meetings because of their relative
insularity.
The
ADPTC has matured rapidly and strikingly in recent years. Our current mission statement actually
does not focus on directors but focuses on the role of training clinics in
training psychologists. Much of what we do is focused on strengthening and
improving the clinics' diversity, fundraising, research, and competencies rather
than the directors. And we have become a significant voice in the broader
training council community for these issues and for practicum training more
generally, which we have worked to balance with our focus on directors and their
concerns.
I
think it's a reality that we've gotten on strong footing nationally, the more so
lately as practicum has come into focus for the field. We have a real and
significant base of experience as practicum trainers that benefits the field.
This has led to the two joint meetings with CUDCP and APPIC. I remember very
clearly now ten years ago when Brian Lewis told us that he was talking with the
CCTC folks (I believe it was Paul Nelson, who as Associate Director of the
Education Directorate set up CCTC in the first place) about ADPTC joining the
group. To me this was almost inconceivable -- I was just running this little
clinic, managing caseloads and supervisors and clients and students -- what
would clinic directors have to say at a meeting like this? I also remember how
amazingly great it was to find a group of people with common concerns and
interests. So I'm thinking of "maturity" both in terms of our recognizing and
embracing our broader national role, but also in terms of our ability to do this
while remaining close to one another, and keeping our core values of sharing
with each other and helping each other, which are kept alive so nicely by our
great website and listserv, the wonderful newsletter that Phyllis does, and
by our meetings. I do think that we have struggled a bit at our annual meetings
to find a good balance between bigger issues and our own down-home clinic
issues. But in fact we are not a "bigger" organization in terms of numbers of
members -- we are "bigger" in terms of our importance to other training councils
and to the field more generally. Can be remain close to one another as we become
more important to others? I'm thinking we can.
It's
on this basis that I'd recommend we should seriously consider a name
change.
Other
thoughts:
Vic Pantesco,
Ph.D.
I
have two lingering thoughts.
The
first is pragmatic: what about
other clinics (non doctoral, for example) that can or could lay claim to
training psychologists? In Vermont,
I believe, there is a Masters level psychologist license, for example. And in the current market of licensed
mental health providers proliferation, what might we want to look at
carefully? There may be legal or
other sensible blocks to excluding any clinic that trains "psychologists." Etc.
The
second is one I have been personally watching for years, and it turns on Bob's
word "matures." I wonder what that
means? Getting so big and powerful
so as to have a forming voice, etc. I suspect within important big picture
matters as Bob suggests. And this
is important. But I sorely hate to lose that quality of relationship,
camaraderie, shared awareness of each other's jobs and life at a very unusual
level, that must happen with bigness and maturity. I perceive for me anyway that some of
that loss is already happening.
A name shift question could only rise to
this level when thresholds of maturity are already pushing at the corners. So I for one think we need to engage our
growth with the candor, insight, forward-looking perspective, and values that
have made us "what we are" - or at least what we have been. This exchange so far still shows our
stuff.
The Briar Patch:
Thorny
"Minor" Challenges for Directors
Getting
Stale
Vic Pantesco, Ph.D.
The Thorn: The Line
Between "Veteran" and "Jaded" - A Subtle Creeper or a Great
Divide?
Reflecting recently on my first ADPTC meeting in Dallas in 2001, I
considered two things: how there
were only about 12 of us in a small half circle, and that I have been doing this
Director work for over nine years now.
While this has been rich on a few levels for me, and edifying for the
most part to see the organization grow, part of my review bent ever so subtly
yet compellingly to an awareness of familiarity bordering on – dare I say it –
staleness.
Perhaps we have research on this:
when, on average, in certain samples, controlling for appropriate
potential confounds, a psychologist may begin to experience this as a Director
of a training clinic. In
unscientific, cliché:
been-there….
Some
places I noticed this in this year:
doing my orientation in-service regarding documentation, which was OK,
but a slight twinge at the inevitable and repeated question that comes just
short of accusing us of terminal anality.
Or, how the computer's not working in room 4 just about did in someone's
ever succeeding in this field.
I suppose it is about patience in the face of sameness in the predictable
negatively energized places within what we do.
To Dull the
Pain
This may not so much be about dulling the pain as about injecting energy
and perspective. Our clinic
team of supervisors remains a source of support and initiative. Here is a place in which longevity has
been an enormous benefit. Our team
has been intact and working together for over seven years. We know each other well to the point of
support and affiliation that goes beyond the nitty gritty, and this includes our
ability to tend to our levels of frustration or jadedness, where they come from
(specific to a group of students, house politics, budget,..., or a clutch of life pressures beyond the
clinic [what, can there be life beyond the clinic?!]), and possible pathways for
coping and solution.
There is fun too of course.
If I begin to lose sight of that it's a sure sign of trouble. So, our department is going bowling in
two weeks. I have set up a contest
in which one may bring suitably adorned bowling pins to put in the racks, and if
you get a strike with that in the head pin slot, you get the prize. The prize? -- Membership on a committee that meets
weekly for two hours with no agenda.
Just organizing this got juices flowing in the fall here in New
Hampshire.
Our work I find is never boring, but it can invite impatience with the
familiar that may breed burnout.
And of course, each year the new hearts and minds beckon me to reach once
more into the place of excited teaching and training, con brio.
Vic getting
some much-needed therapy from his rock troll therapist on Block Island, RI last
summer.
Technology:
Keeping
Electronic Records with Carepaths
Colleen Byrne,
Ph.D.
Since
early 2005, the Psychology Clinic at the University of Maryland in College Park
has been using the Carepaths for
electronic record-keeping. In hopes of both simplifying our record-keeping and
also cutting paper costs, we switched to electronic record-keeping with Carepaths. I originally learned about
Carepaths from Eric Sauer. Although I had intended to use it only
for the OQ45, I gave the electronic record-keeping function a trial run and
ended up liking it a lot. CarePaths
offers the eRecord, "a multi-modal, web-based Behavioral Health Electronic
Medical Record (EMR) and Practice Management system." It is a "secure, web-based
and HIPPA-compliant record-keeping system". It is also highly customizable. Our
Clinic uses only 30-40% of Carepaths's available services.
For
our Clinic, the main benefits of using Carepaths are 1) low cost as compared
to products like Titanium, 2) the convenience of access from any secure,
internet-connected computer, and 3) the security provided by customizable access
levels for supervisors, practicum students, and support staff. Additionally, electronic record-keeping
has increased efficiency and accountability for practicum students and
supervisors alike. The web-access is a good fit for students with hectic
schedules; I find that students have been more likely to write progress notes on
time now that the time and date are electronically stamped. This has been true
for supervisors as well. Electronic record-keeping has made it easier for
supervisors to monitor the progress of a multiple students' work. Also, students
in need of assistance are more easily identified and can be provided with
feedback before the end of the semester.
At the UMD Psychology Clinic, we primarily use the following the Carepaths modules: Progress Notes,
Clinical Screenings; Assessment Center, Intake Assessments, Treatment Planning,
Discharge Planning, Patient Management, and System
Administration:
- In the Progress
Notes module we use the Individual Progress Note, Miscellaneous Contact Note,
and Miscellaneous Service Note;
- In the Clinical
Screenings module we use the Clinical Screen template to record basic
information about a client's presenting problem and treatment
history;
- In the Assessment
Center module we use the OQ45.2, YOQ30, YOQ30-SR, and WAI;
- In the Patient
Management module we enter demographic and contact information for waitlisted
clients. (With a quick change of the medical record number, this becomes their
electronic chart when they are assigned to a therapist); and
- In the System
Administration module, which has restricted access, we use the Groups feature
(to specify user levels) and Security Keys.
Practically, it works like this. After logging on, a user can enter text
for a progress note directly into the template or they can cut and paste from a
MS Word document. The practicum students "sign" their work (by entering their
password next to their name) as "pending", which allows supervisors to review
and/or make corrections before signing a document as "completed". If a student
wishes to have time to self-edit, they can sign their work as a "draft" so that
only they have access until they are ready to submit the document as
"pending."
Carepaths
has many features such as scheduling, internal email, accounting, and billing
that we have chosen not to use. (Since collected funds are processed through our
Psychology Department's business office, we keep billing and scheduling on
separate programs to maximize client confidentiality.) One drawback with Carepaths is that I still need to rely
on the practicum students and supervisors to let me know when a case is closed.
Further, unlike Titanium and some other products, Carepaths does not offer query-type
searches of clients based on demographic or diagnostic variables. (So, if I
wanted to know how many depressed males came to our Clinic in the last year,
there is no quick way to find out). I can't say that Carepaths will work for every Clinic,
but it has been wonderful for us.
![MCj01051880000[1]](Dec2009ADPTCnewsletter_files/image012.gif)
