[AVAPL Members] Re: Licensed Professional Mental Health Counselor

  • From: denise abney <cardinda@xxxxxxxxx>
  • To: members1@xxxxxxxxx
  • Date: Thu, 21 Oct 2010 22:48:42 -0500

ALso, did you know that the "old" MMPI results can be converted to MMPI2-RF
results? WHat a field day.../

On Thu, Oct 21, 2010 at 10:46 PM, denise abney <cardinda@xxxxxxxxx> wrote:

> At a fairly recent MMPI2- RF workshop, Paul Arbisi presented on the new
> restructured scales of the MMPI and mentioned that the research he was
> involved in indicated that the PK and PS scales were not useful in
> determining who may have PTSD since the scale mostly reflected level of
> distress. This made so much sense and a lightbulb went on and has stayed on
> since.
>
> I wonder if administering the MMPI2-RF would help distinguish between level
> of distress and symptomology in patients with PTSD? I've given the MMPI to
> almost every patient I have worked with over the last 18 years. MMPI's of
> many severe cases often suggested that the results were invalid due to an
> unusual level of over-reporting. However when I looked at the pattern of
> scores in the profiles, I could see that it was relatively consistent (high
> 2,4,6,7,8) with PTSD patients with valid profiles. The F scores are always
> high as well unless a patient has developed a lifestyle around their
> symptoms or they have had some treatment. I don't necessarily discard these
> results as invalid or malingering. In fact the Fp scale score often
> indicates malingering is not occurring despite overreporting. The patient's
> presentation is usually consistent in terms of the severity of intrapsychic
> and interpersonal problems. In these cases the F scale score is typically
> very high compared to non-PTSD diagnosed patients which also suggests the
> results are invalid. Unfortunately, others often dismiss these patients as
> malingerers or dismiss results when they indeed indicate a very severe level
> of distress.  And these may be individuals that are in most need of help.
>
> If, when stripped of "distress", the MMPI can be used to look
> at symptomology, it would be very useful in helping to understand PTSD, what
> it looks like in individuals  (and I do believe in subgroups, i.e. relivers
> and avoiders, the defenses they use to cope, a more accurate picture of
> symptom severity, and levels of distress and how they impact assessment. I'd
> want this and the PAI to be included as they are now somewhat complementary
> in my eyes. The PAI needs to be giving to pts with PTSD to develop norms and
> the interpretations can be made available for free if VA is willing to allow
> the testing corporations to analyze the data for these purposes. We have
> years of data on these patients that could be reviewed by assessment
> researchers. Since our system is so large, it wouldn't take much time to
> have huge samples to work with on any test we give. Some VA's could use a
> few tests and others could use other tests for outcome or other variables. I
> could go crazy thinking of the possibilities for assessment research. I have
> always wanted to see assessment clinics in the VA. We could diagnose and
> recommend good treatment for more patients and be very efficient about it.
> I think we need to look as defenses in assessment. Many PTSD patients have
> been misdiagnosed, for example, as narcissistic personality disorder because
> their defenses are of this type. There are lots of variables which come from
> the old fashioned womb to tomb evaluations... trauma history in childhood,
> coping styles in childhood, social support in childhood and the same
> variables in adulthood after adult trauma and on and on.  One especially
> pertinent variable would be related to the wax and wane of symptomology in
> every patient as test results differ depending on where the patient is with
> their symptoms at the time - again - level of distress and stress play a
> role.  If we already do these things than why not template the evaluations
> and use the data for research. It would help with training, we could look up
> this information for patients on an as needed basis for other clinicians,
> for ourselves, track progress in therapy with variables.....How could other
> VA clinicians argue with that large a sample? Tracking people over time? You
> would have hard data to show and explain to others. It might remove the
> compensation seeking issue. Can't a person who is ill seek compensation too?
> If  our history of assessment with these tools has provided us with respect
> over the years, it only makes sense to me to stay committed to what we have
> been most successful at and what has distinguished us from others.
> Enough
>
> Denise Cardin Abney
> San Antonio
>
>
>
> On Fri, Oct 15, 2010 at 5:56 AM, Hagans, Chad L. <Chad.Hagans@xxxxxx>wrote:
>
>>  That sounds like a great idea, Kathleen.  I would encourage anyone
>> attempting such research to include measures of response style, since the
>> reputation of our profession within the VA may be affected by the results.
>> I’m attaching an article with more details for those who are interested.
>>
>>
>>
>>
>>
>> Chad Hagans, Ph.D.
>>
>> Licensed Psychologist
>>
>> Pensacola Joint Ambulatory Care Clinic
>>
>> 850-912-2000 ext. 2091
>>
>>
>>
>> *From:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *McNamara, Kathleen M.
>> *Sent:* Thursday, October 14, 2010 3:05 PM
>>
>> *To:* members1@xxxxxxxxx
>> *Subject:* [AVAPL Members] Re: Licensed Professional Mental Health
>> Counselor
>>
>>
>>
>> Quite a number of years ago, the APA Practice Directorate had a project
>> with Atlantic Bell South which showed a significant reduction in costs when
>> psychological assessments (objective testing like MMPI) were used with those
>> who were covered under insurance by them.  The savings came from proper
>> diagnosis and follow-up treatment recommendations,  with significant
>> reduction in psychiatric hospitalizations, in particular.
>>
>>   Unfortunately, when I have tried to track down anything published or
>> even a summary report, I have been informed that the data were proprietary
>> and it is not a published finding.  I would like to see the Denver VA study
>> (or have the reference), if you could please forward that to me.  Thank you.
>>
>>
>>
>>
>> It would be great if we had some efforts from OMHS to coordinate a study
>> across VA MHSs to do a large scale study, where psychological assessments
>> were included in Intakes to make diagnostic decisions, and then utilization
>> and/or costs for things such as: medications, hospitalizations, and
>> subsequent number of visits to each of the various MH  provider groups
>> (psychologist, psychiatrist, social worker, counselor) over a two year
>> period could be tracked.  I think our resources would be well spent.
>>
>>
>>
>>
>>
>> Kathleen M. McNamara, Ph.D., ABPP
>>
>> Lead Professional, Psychology
>>
>> Staff Psychologist, Maui VA CBOC
>>
>> 808-871-2454
>>
>>
>>
>>
>>
>>
>>
>> *From:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *Hagans, Chad L.
>> *Sent:* Thursday, October 14, 2010 7:59 AM
>> *To:* members1@xxxxxxxxx
>> *Subject:* [AVAPL Members] Re: Licensed Professional Mental Health
>> Counselor
>>
>>
>>
>> Right, but how much money does it save when you use it? J
>>
>>
>>
>> I think that’s the question the people making the decisions are asking,
>> unfortunately.
>>
>>
>>
>> Now, is anyone in our field working on answering that question?
>>
>>
>>
>>
>>
>> Chad Hagans, Ph.D.
>>
>> Licensed Psychologist
>>
>> Pensacola Joint Ambulatory Care Clinic
>>
>> 850-912-2000 ext. 2091
>>
>>
>>
>> *From:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *Evans, F. Barton
>> *Sent:* Thursday, October 14, 2010 12:55 PM
>> *To:* members1@xxxxxxxxx
>> *Subject:* [AVAPL Members] Re: Licensed Professional Mental Health
>> Counselor
>>
>>
>>
>> Well said, William.
>>
>>
>>
>> There is an  empirically well supported treatment method called
>> Therapeutic Assessment (TA) developed by Dr. Stephen Finn in Austin which
>> integrates psychological assessment and treatment.  There was even a study
>> done at the Denver VA successfully using TA with suicidal veterans. If
>> anyone is interested, I would be glad to send information next week.
>>
>>
>>
>>
>>
>> F Barton Evans, PhD
>>
>> Clinical Psychologist
>>
>> VA Montana Health Care System
>>
>> Bozeman CBOC
>>
>> Bozeman, MT 59715
>>
>>
>>
>> Clinical Professor
>>
>> Department of Psychiatry and
>>
>>   Behavioral Science
>>
>> George Washington University
>>
>>   School of Medicine
>>
>>
>>
>> CONFIDENTIALITY NOTICE:
>>
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>>
>>
>>
>>
>> *From:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *Crisp, William
>> *Sent:* Thursday, October 14, 2010 11:01 AM
>> *To:* members1@xxxxxxxxx
>> *Subject:* [AVAPL Members] Re: Licensed Professional Mental Health
>> Counselor
>>
>>
>>
>> What sets psychologists apart and makes them valuable is their training
>> and ability to conduct research and do assessments. Many psychologists seem
>> to have ignored these assets in favor of developing things like manualized
>> training which opens the door for other disciplines to do our work.  In many
>> VA settings research and assessment are discouraged as time consuming and
>> less important than therapy, case management  and documentation.  Instead
>> psychologists should develop protocols which emphasize both assessment and
>> research as guides to treatment.  This could greatly improve treatment over
>> generic style manualized treatment and demonstrate the value of
>> psychologists.
>>
>>
>>
>> William Crisp, Ph.D.
>>
>> Clinical Psychologist
>>
>> Substance Treatment Employment Program
>>
>> Central Texas Veteran’s Health care System
>>
>> Temple, TX
>>
>>
>>
>> *From:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *Hagans, Chad L.
>> *Sent:* Wednesday, October 13, 2010 8:03 AM
>> *To:* members1@xxxxxxxxx
>> *Subject:* [AVAPL Members] Re: Licensed Professional Mental Health
>> Counselor
>>
>>
>>
>> In my opinion just another failure by psychology to demonstrate
>> empirically the value of what we offer over and above the value of what
>> other mental health professionals offer, if indeed that value exists.  I’d
>> like to think it does because I’m a psychologist, but to say it does without
>> empirical evidence would indicate bias more than anything else in my
>> opinion.
>>
>>
>>
>> It’s time to get to work and demonstrate the value.  Who wants to do the
>> work?
>>
>>
>>
>>
>>
>> Chad Hagans, Ph.D.
>>
>> Licensed Psychologist
>>
>> Pensacola Joint Ambulatory Care Clinic
>>
>> 850-912-2000 ext. 2091
>>
>>
>>
>> *From:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *Long, Stephen
>> [Northport]
>> *Sent:* Thursday, October 07, 2010 3:30 PM
>> *To:* 'members1@xxxxxxxxx'
>> *Subject:* [AVAPL Members] Re: Licensed Professional Mental Health
>> Counselor
>>
>>
>>
>> Edgardo, you sound the way I feel at times like these.
>>
>>
>>
>> It is very difficult to see so much of what one has worked for (developing
>> skills, making what contributions you can, getting doctoral and postdoctoral
>> training) over a professional career to have much of that devalued, denied,
>> dismissed.
>>
>>
>>
>> *om:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *Kirchberg, Thomas
>> *Sent:* Thursday, October 07, 2010 11:49 AM
>> *To:* members1@xxxxxxxxx
>> *Subject:* [AVAPL Members] Re: Licensed Professional Mental Health
>> Counselor
>>
>>
>>
>> Thank you, Edgardo.  I value your viewpoint on all the issues you raise!
>>
>>
>>
>> Tom
>>
>>
>>
>> *Thomas M. Kirchberg, Ph.D., ABPP*
>>
>> *Chief Psychologist*
>>
>> *Mental Health Service*
>>
>> *VA Medical Center Memphis*
>>
>> *901-523-8990 ext. 5320*
>>
>>
>>
>> *From:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *Padin, Edgardo (VHACLE)
>> *Sent:* Wednesday, October 06, 2010 9:55 PM
>> *To:* members1@xxxxxxxxx
>> *Subject:* [AVAPL Members] Re: Licensed Professional Mental Health
>> Counselor
>>
>>
>>
>> By interesting, I’m sure you mean discouraging.  After 20+ years in the
>> VA, I continue to be astounded at how so many other professions continue to
>> have sufficient advocacy to increase their grade levels commensurate with
>> their responsibilities (case in point, Social Workers continue a juggernaut
>> rise in grade with each new “position” created (most now seemingly needing
>> GS-12 grades) while psychologist have an almost insurmountable task getting
>> approvals at the GS-14 level.  The data notwithstanding (that we have
>> increased the number of GS-14 positions), the success of our Hybrid T38 and
>> Professional Standards Boards have been underwhelming.
>>
>>
>>
>> This is not to start an old argument about our glass ceiling as
>> psychologists in the VA; but it is to say that this new initiative to bring
>> in and somehow “Qualify” Master’s Level Counselors is a lobbyist win by
>> Master’s Level Counselors and Counseling Programs to establish their niche
>> in the VA.  And it will ultimately be to the detriment of Psychology.  A
>> system of lower entry pay entry “counselors” who can rise to the GS-13 by
>> taking on greater responsibility means fewer Psychologists will be needed as
>> they become overseers of a cadre counselors doing more of the supposed
>> “drone” work of fully manualized and technicalized therapy.  What a Brave
>> New World.  Anyone who thinks this is not the case should look at the
>> private sector and see how lower level “Assistants” are replacing part of
>> the work (and the pay) of their more educated colleagues.
>>
>>
>>
>> Let me clarify here that I have nothing against Master’s Level Counselors,
>> we have used them in Cleveland ever since I have been here.  I don’t know
>> who is trying to kid whom whey they say that this is a “new position” of
>> Mental Health Counselor, but we have had GS101-11 Readjustment Counselors in
>> the VA for well over thee decades. They have limitations, but have worked
>> out well in the areas we have used them.  But what I do know is that not a
>> single one has ever shown that they have some secret knowledge or facility
>> or skill and foundational learning that is different from, greater than, or
>> particularly more technical in nature that Psychologists.  Usually, they
>> have less.  The only difference now is that some accreditation body (CACREP)
>> can now be added as a profession lobbying body in the VA.  Personally, I am
>> not amused.
>>
>>
>>
>> So, maybe we as Psychologists are too educated, maybe manualized,
>> evidence  based protocols are making our “therapy” work too rote and
>> straightforward for the amount of pay we are demanding, maybe what we do,
>> with a good cookbook here and an evidence based therapy there, can be done
>> by cheaper labor.  I’m not sure; but I will say that with this cannon shot
>> of promoting our Master’s Level colleagues, we will find out.  End of rant.
>>
>>
>>
>>
>> *From:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *Fischer, Pamela (OKL)
>> *Sent:* Wednesday, October 06, 2010 10:52 AM
>> *To:* members1@xxxxxxxxx
>> *Subject:* [AVAPL Members] Re: Licensed Professional Mental Health
>> Counselor
>>
>>
>>
>> It is interesting to me that the LPC who is a program manager can be a GS
>> 13 – the grade level that many psychologists who manage programs and have
>> years of experience cannot move beyond.
>>
>>
>>
>> Pamela C. Fischer, Ph.D.
>>
>> Director, Primary Care Mental Health #111AC
>>
>> Veterans Affairs Medical Center -OKC
>>
>> 921 N.E. 13th Street
>>
>> Oklahoma City, OK 73104
>>
>> Phone: 405-456-3634
>>
>> Fax:     405-456--5956
>>
>> *From:* avaplmembers-bounce@xxxxxxxxxxxxx [mailto:
>> avaplmembers-bounce@xxxxxxxxxxxxx] *On Behalf Of *Shorter, George Wiley
>> *Sent:* Tuesday, October 05, 2010 8:54 AM
>> *To:* members1@xxxxxxxxx
>> *Subject:* [AVAPL Members] Licensed Professional Mental Health Counselor
>>
>>
>>
>> Colleagues,
>>
>>
>>
>> As many of you have been awaiting the Qualification Standards for Mental
>> Health Counselors, we wanted to share these with you when we first received
>> it.
>>
>>
>>
>>
>>
>> George Shorter, Ph.D.
>>
>> President, AVAPL
>>
>>
>>
>>
>>
>> *"The willingness with which our young people are likely to serve in any
>> war, no matter how justified, shall be directly proportional as to how they
>> perceive the Veterans of earlier wars were treated and appreciated by their
>> country."   -George Washington*
>>
>>
>>
>>
>>
>>
>>
>>
>>    [image: PolicyUpdate]
>>
>> *Date:  9/29/10                                                  ID#:
>> 2010-25*
>>
>> *Policy Office:**  Recruitment & Placement Policy Service (059)**
>> Contact:  **Kent A. Wellman (Kent.Wellman2@xxxxxx) *
>> *Policy Subject:**  VA Handbook 5005, PT II, Chapter 2, Appendix G43,
>> Licensed Professional Mental Health Counselor qualification standard.*
>>
>> *Handbook Reference:* 5005
>>
>> *The attached new VA qualification standard for Licensed Professional
>> Mental Health Counselor, GS-101 has been signed.  Since this is a new
>> occupation to VA there will NOT be an initial one-time boarding.  Additional
>> implementation instructions and guidance will be forthcoming from the
>> Veterans Health Administration (VHA).  The new Appendix G43 will be added to
>> the electronic version of VA Handbook 5005, Pt II, located at
>> http://vaww1.va.gov/ohrm/HRLibrary/Dir-Policy.htm***
>>
>> *Questions regarding this Policy Update should be addressed to the Title
>> 38 Staffing Policy Section, 
>> mailto:staffingpolicy059/vaco@xxxxxx<staffingpolicy059/vaco@xxxxxx>.
>> *
>>
>> *Status: Policy Process Step 4*
>>
>> *Estimated date of release/implementation:*  9/29/2010
>>
>> This policy alert e-mail is part of a notification process that is
>> intended to alert HR Specialists and other interested parties that a new
>> policy or change to existing policy is required or being considered. If you
>> have specific questions regarding this policy alert, please address them to
>> the contact person named above. Policy update e-mails regarding this policy
>> subject will be automatically generated according to the policy
>> communication schedule/timeline. For more information about this policy
>> alert or the policy communication schedule/timeline please go to *
>> http://vaww.va.gov/ohrm/ <http://vaww1.va.gov/ohrm/>*
>>
>>
>>
>>
>>
>>
>>
>>
>>
>
>

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