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This community blog is written by the current OPA Board of Directors' President.

 

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President's Message: April 2019

Posted By Katharine Hahn Oh, PhD - OPA President, Thursday, April 11, 2019

How can we promote Psychology to the public in Ohio? In a marketplace with many other mental healthcare providers, how do we distinguish ourselves? This will be the topic of our Spring Assembly at Convention: Wednesday and Thursday mornings at 8:00! Grab your coffee and join us to brainstorm some action steps for this strategic plan goal. We’ll hear what the OPA Marketing committee is already doing and discuss further ideas. As APA gets into the business of establishing criteria for Master’s programs in Psychology, some have worried that our distinction as doctoral-level psychologists could be further eroded. This Assembly will give us the chance to develop ideas about how to clarify the differences between master’s level and the doctoral training so that clients know what to ask for and what to expect.

While psychologists manage some sense of fear that we could lose clients to master’s level clinicians, we know that there is a shortage of mental health care (plenty of clients for everyone). As I think about the larger perspective, my sense is that the underlying problem is access to healthcare, rather than not enough clients for all of us. In my work at CSU’s Counseling Center, we are able to provide short-term therapy for free to students, but then we have to refer out for continued longer-term work. This allows us to provide some care for all students who want it. Our clients sometimes have good insurance, but even then, the deductibles can be prohibitive! For people with really good health insurance and plenty of income, mental health care is accessible. But for those without extra funds to pay deductibles and co-pays, significant barriers exist. We also see a lot of students who have no insurance. If they are eligible for Medicaid, the process of signing up is bewildering and long.

For decades, young adults have been at higher risk for suicide, and the trend for college students over the last five years is increased suicide risk and self-harm. When these students go without treatment, we risk seeing more deaths by suicide. So, the barriers to long-term therapy create heightened risk. I see this problem as both ethical and related to diversity. How can we ethically allow people at risk to go without treatment, knowing that their lives may then be in danger? While we know that those with money and privilege have access to care (hence well-being and safety) while those without do not, how can we do nothing?

As I enter my last year as an Early Career Psychologist (10 years since doctorate), I see more and more how our work is affected by the social and political context of healthcare and access to mental health treatment. My first four years at Cleveland State University, working with a diverse urban student body, have coincided with my greater involvement in OPA where I’ve learned more about Advocacy. Together these experiences have given me a passion to try to change the system that leaves some people well and others at risk.

If Advocacy is something that interests you, I encourage you to get connected with one of OPA’s committees. Some committees actively engaged in advocacy are the Diversity Committee, the LGBT Sub-committee, and the Advocacy Committee. As we start to implement our Strategic Plan goals, (1) we will be helping psychologists understand how national advocacy for Medicare changes impacts Medicaid and private insurance reimbursement, (2) we will be developing strategies to hold insurance companies accountable for mental health parity, (3) we will be supporting legislation that addresses issues of diversity and cultural competency, and (4) we will work to get the RxP bill passed and begin working to get PsychPact on the legislative agenda in Ohio. These concerns impact both psychologists and the public, allowing us to provide much-needed services and opening up greater access to treatment.

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President's Message: March 2019

Posted By Katharine Hahn Oh, PhD - OPA President, Friday, March 22, 2019

Practice Leadership Conference last week was energizing and inspiring! I started the conference with the Ohio Delegation at the opening reception and ended on Capitol Hill advocating for increased access to mental health care. One highlight of the first evening was the amazing dinner hosted by Jim Brush and his wife in their home in D.C. Jim made pad thai from scratch and got it just right, a real trick! We discussed their interest in getting more federal representation for D.C. (as they have no senators or representatives at the federal level) and his wife’s experiences when she lived in Afghanistan. The beautiful green embroidered tablecloth and napkins we used were purchased there at the same time that a bombing was occurring on the other side of town. 

Sunday and Monday were filled with keynotes and conference sessions. I attended a few extra informational sessions as well: a briefing with Chief of Practice, Dr. Jared Skillings, who will give our keynote at the OPA Convention in April; and a session on the master’s accreditation issue. Both of these discussed how APA is changing to meet current challenges. Dr. Skillings addressed the need to think more creatively about what we have to offer that is different from our market competitors, and the master’s issue program reviewed both opportunity and challenge as APA seeks to provide accreditation criteria for master’s programs in Psychology. I also attended sessions on the Opioid Crisis and Applied Psychology (thinking about what we have to offer in industry, government and other sectors). 

Dr. Sandra Shullman, APA President-Elect moderated a panel of leaders and asked them to share a challenge they faced and what they learned from it. This was perhaps my favorite content from the entire conference. The insights shared rang true for me: “when you take on a leadership role, you never know what you are signing up for.” They discussed challenges that were unexpected and that they could not prepare for but which they somehow met well enough. Dr. Arthur Evans, APA’s CEO, described the day he was recruited for a position when the current leader was suddenly fired, and he walked over to see all his new employees walking out in protest about the change in leadership. He went on to succeed in that role and then get hired as APA’s CEO! 

On Sunday night, I had the privilege to attend the black tie dinner with Senator Bill Cassidy from Louisiana. I am grateful to all the members of OPA who helped contribute to the price of my seat there! It is perhaps one of the few times I will attend an event with a $1000 price tag. At my table were some of the heavy-hitters for APA Advocacy (a professional lobbyist, Dr. Skillings, Dr. Jennifer Kelly who is running for APA President, and others). So I let them talk when Senator Cassidy was present, and they made a good pitch for increased access to healthcare through House Bill HR 884, “Medicare Mental Health Access Act.” Once he moved on to the next table, his aide, Mary Moody, sat with us, and I took the opportunity to talk with her about an issue close to my heart: suicide prevention on university campuses. When I mentioned that suicide prevention does not receive as much funding as it should, given the death rates by suicide, she was already aware and had done some research on this. When I mentioned how veterans are disproportionately affected, she agreed and talked about what she was learning about suicide among women veterans. Overall, I hope I made a small impact, but it was a wonderful opportunity to have relaxed time with Senator Cassidy and Mary Moody. 

On Monday, I got to participate in a “pure democracy” experience. I put my name in the hat to run for Committee of State Leaders (the group that plans Practice Leadership Conference each year). I had one minute to talk about why I should be elected, and then those present could vote. It was nerve-wracking to talk in front of so many experienced leaders, but I won! Thanks to Jim Broyles and Michael Ranney for helping me with my speech on the walk there!
Finally, the capstone of the experience is always the day on Capitol Hill. I got to advocate with Jim Broyles and Adrienne Jett at two Republican Representatives’ offices. As we got warmed up, we engaged more personally with the aides, and it was good to get to know them a bit. We will be following up with them to continue our advocacy and relationship-building. The three asks from APA were: support the Medicare Mental Health Access Act, support the Mental Health Telemedicine Expansion Act, and generally preserve mental health and substance use disorder coverage in Medicate and private health insurance plans. We also provided some information about Argosy (Dr. Evans had sent a letter to Betsy DeVos to advocate for their students), and we mentioned that we will follow up with the appropriate aide to discuss OPA’s concerns about the separation of immigrant families. It sounded like the representatives were aware of the increased need for mental health care, partly due to awareness of the opioid crisis. Whether or not they will support these bills is uncertain, but it was good to just begin the relationships. 

If there was a take-home for me, it was the importance of relationships. I had some lovely conversations in between things with Adrienne Jett, our ECP Committee Chair, and learned more about her work in the prison. I shared a cab and lunch at the airport with Kathy Ashton and got to get her advice for the rest of my presidential year in OPA, and I had time to talk with Michael Mobley who served with me on the Board of Division 17 (Society for Counseling Psychology). He was present at PLC as a Public Interest delegate, and we talked about the stresses of our leadership roles at work (he’s on faculty at Salem State during a transition time) and play (he’s chair of APA’s Board on the Advancement of Psychology in the Public Interest). I also stole as much time as possible with Sandy Shullman who has been a mentor for me. It was great to watch her relationship with current APA President Rosie Bingham. I can see how Rosie and Sandy will each do what is best for APA in their year and then hand the baton to the next one to lead the organization forward. They’ve committed to this strategy of collaboration and organization-first over personal priorities. I left the conference warmed by these relationships and inspired for the year ahead!

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President's Message: February 2019

Posted By Katharine Hahn Oh, PhD - OPA President, Wednesday, February 27, 2019

As I prepare for this year’s Practice Leadership Conference in Washington, D.C., I am struck by how connected all of our work is. In my day-to-day practice at a University Counseling Center, I do not have to bill insurance, but it is clear to me that advocacy for improved insurance reimbursement and parity of mental health and physical health coverage are essential to my work. At most University Counseling Centers now, we have a population approach to mental health and try to provide for the needs of all students at the school. Of course, we cannot provide for all needs of all students and so offer an array of services like crisis walk-in sessions, group therapy, psychiatry, case management, workshops, after-hours crisis phone counseling, and individual therapy. The individual therapy is short-term so that we can maintain quick access to services. As a result, we rely on being able to refer out students with longer-term needs or more specialized needs (e.g., eating disorder or substance dependence treatment). When students don’t have insurance or their insurance has such high deductibles and co-pays that they cannot afford to use it, we are confronted with the barriers people experience in accessing care. With our new clinical case manager, we can sometimes get students access to care through Medicaid, but the process of signing up for Medicaid is daunting. When students have severe symptoms, feel ambivalent about getting more treatment, and have tight schedules with work and school, it can seem nearly impossible to help them access needed care.

This issue of access to care is the main topic of our Capitol Hill visit this year in D.C. On Tuesday, March 12, hundreds of psychologists from across the country will be on the Hill to visit with our Senators and Representatives (or their very sharp aides). APA staff members will prepare us to advocate (1) for telehealth to be covered by insurance (the Mental Health Telemedicine Expansion Act), (2) for psychologists to be able to provide services without physician approval under Medicare (Mental Health Access Act or “Physician Definition Act”), and (3) for general support of health care coverage. In addition, we may organize our Ohio delegation to speak intelligently about the issue of families being separated during the initial immigration process here. APA has already advocated for change in this practice, and we may be able to speak personally with our Congress people about our concerns. 

Then at a black-tie dinner organized by APA’s Political Action Committee or PAC, I will have a chance to talk with Senator Bill Cassidy, Republican from Louisiana. Previously, he founded a free clinic in Baton Rouge and worked as a gastroenterologist. In the House of Representatives and now in the Senate, he has been a champion for mental health care and coverage. Last year, he fought to maintain Medicare payment for psychological testing. I am inspired by his approach to improve access to care for people most in need and by the fact that we come from different political parties but share a passion for access to mental health care.

At APA and perhaps in OPA as well, there has been a distinction at times between advocacy for issues that are considered “practice” issues vs. those considered “social justice” issues. My participation in meetings this month has encouraged me to begin to challenge this dichotomy. In the February OPA Board meeting, the Insurance Committee joined us and shared the work they have been doing and how their work helps psychologists offer adequate care. Several of the committee members and board members framed their work as social justice work which allows clients to have access to care. For instance, insurance companies may take actions that seem to discourage more than a 45-minute therapy session, but for many clients, that length of session may be inadequate. We know from research that conducting a brief measure of symptoms (e.g., OQ-45 or CCAPS) before treatment and periodically throughout treatment improves outcomes and may reduce the number of sessions needed; however, insurance tends to barely reimburse or not reimburse these brief measures. The work of understanding and advocating for changes here can seem quite technical and specific to practice that relies on insurance billing. However, from a broader viewpoint, it is clear that clients relying on insurance (which is most of us) may not have access to all the care we need without this advocacy. Those with fewer resources are perhaps the most impacted by these barriers to care, and thus, advocating for “practice issues” is social justice work.

At a webinar with APA staff who were preparing delegates to address a “social justice” issue of our choosing on Capitol Hill, participants spoke passionately about their practice being inherently social justice oriented. One participant shared that the majority of his clients are from the LGBTQ community; thus, the distinction between practice and social justice issues is not a real one in his lived experience as a psychologist. Anyone working with underserved clients or those with fewer resources may feel the same. 

I wonder how we might continue to break down this dichotomy in our work at OPA. Where we have both Republicans and Democrats, agnostics and Christians, liberals and conservatives in our association, can we see how our practice advocacy improves access for all and thus advances social equality? My guess is that we may have many differences in worldview across our members, but we all value the health and well-being of all people, whether it be LGBTQ clients or children just immigrating to the U.S. with their families. 

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President's Message: January 2019

Posted By Katharine Hahn Oh, PhD - OPA President, Tuesday, January 29, 2019

Last week my mother received a small round of applause from the librarians when she returned the final volume of Gibbon’s Decline and Fall of the Roman Empire. She may be the only one this century in her small town to have read the entire work. In her retirement, she is reading books, watching documentaries, and continuing her lifelong studies. Her love of learning was clearly passed down to me, and as a psychologist, I see lifelong learning as a value in our field as well. At our midyear reflection on our work, my Counseling Center staff commented that we are committed to continuing to learn in order to maintain the quality of our services, but they also commented that they just enjoy learning. What is it about learning that you love? 

When you take the Gallup Strengths Finder, you are provided with your top five strengths, and three of mine are Ideation, Intellection, and Learner (the other two are Achiever and Relator). This means I could come up with ideas all day long and that I love to think about ideas and learn just for the sake of thinking and learning. If I didn’t have Achiever in my top five, I might struggle to complete any projects! In any case, my answer to what I love about learning is “nearly everything.”

Becoming President of OPA, I worried that I didn’t know enough about all aspects of psychology in Ohio, but I’ve found that it’s been a joy to learn more (and that, thankfully, I don’t have to know it all). This year, I’ve learned more about challenges in getting reimbursed, about what a quality worker’s compensation evaluation includes, and about the many aspects of the opioid crisis. 

I find myself curious about local and statewide efforts to improve the well-being of children by increasing the number of school psychologists (there is a severe shortage), by subsidizing childcare, and by cleaning up the lead problem in our housing here in Cleveland. This year our OPA Board includes several members who work with children or in children’s settings, and I’m curious to learn more about their perspectives on these urgent concerns that appear to have bipartisan support. How might we use this opportunity to be proactive in our work to improve the lives of Ohioans? 

These are the kinds of questions our OPA Board wants to discuss this year. At our last Board meeting, we took a critical look at how we spend our time during meetings and decided to experiment with a different type of agenda. This spring we will be alternating our focus from business items in one month to a broader discussion of more strategic issues the next month. We want to do a good job of anticipating the challenges and opportunities facing our field and the public and guide our association to lead more proactively. This change also allows all of us to learn how to frame and participate in these broader discussions. As we try something new, not yet knowing quite how it will work out, I feel the excitement/anxiety that comes with learning a new skill and working at my edge. As a Board, we are practicing what Sandra Shullman calls “learning leadership” as we learn the situation and the skills while leading.

Of course, not all learning is joyful. As I talk with people who face significant challenges at work or who have intense caregiving responsibilities with family who have health concerns, I know that learning we wouldn’t choose is sometimes imposed on us by life. When life has given me challenges and lessons that go beyond a healthy stretch, I’ve heard myself say, “well, I’m learning a lot” as a way to look on the bright side. But much of the time lately, I’ve been able to choose what and when I learn, and then the experience is mostly joyful. In this new year, I wish for each of you to come through challenging times and to have moments – or years or decades – of joyful learning. 

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President's Message: November 2018

Posted By Katharine Hahn Oh, PhD - OPA President, Tuesday, November 20, 2018

Such good news: our own Dr. Sandra Shullman has been elected for APA President! She currently holds the title of President-Elect-Elect, but she is also a Past President of OPA and a global leadership consultant. I am so glad she will be at the helm of APA during this transformational time. A few weeks ago, just after we received the news that she had won, I had the privilege of co-presenting with her at our OPA Leadership Development Academy. I was reminded of how humble her presence is, as she is always looking to see what is needed by the group she is with, rather than providing a standard set of ideas. She is more of a listener and more of a thinker than most leaders I know.

At the Leadership Development Academy (LDA), we had 10 up-and-coming OPA leaders as fellows: Kistry Engel, Adrienne Jett, Katy Jones, John Lodge, Kadian Miracle, Jeeseon Park-Salzman, Amanda Ross, Geoff Schwerzler, Brittany Sommers, and Chiaothong Yong. They work in private practice, state hospitals and pediatrics, at college and university counseling centers, and in veterans’ substance abuse treatment. I am excited about the diversity of experience and perspective they will bring to OPA’s future. As a group, the LDA fellows were attuned to the collaborative, mission-focused, and organization-focused leadership that Sandy and I spoke about. Some of their ideas of leadership include...

  • creating a culture of trust
  • maximizing team strengths
  • acknowledging failure, biases, weaknesses
  • coming back from failure (being resilient)
  • being genuine
  • promoting participation
  • being brave
  • respecting diverse views
  • managing conflict
  • adapting to the group

It seems we have a group of generous leaders in our future, and it was a joy to spend a day with them at their first training. The LDA fellows will meet online with the faculty, attend Board meetings, work with a mentor, and complete a project over the course of the year. 

Sandy spoke in her presentation about her concept of being a “learning leader” (Shullman, 2017). Given the fast pace of change in our world and in our profession, how do we as leaders help navigate through this change? Sandy described the qualities or skills that have best helped leaders succeed in times of great ambiguity like these: (a) curiosity and motivation by mystery, (b) risk tolerance, (c) future scanning, (d) tenacity, (e) personal excitement and enthusiasm of others, (f) flexibility, (g) simplifying, and (h) focus.

Both APA and OPA are currently in a Strategic Planning mode, with our OPA strategic plan all but finalized. Our process has been one of learning and stretching ourselves to meet the current needs in our world and profession. For instance, one goal focuses on reducing the Opioid Crisis, and one initiative is to increase our work with First Responders. Related to our profession, we hope to assist APA’s advocacy for better reimbursement with Medicaid and Medicare and to increase psychologist involvement in state government committees and task forces. Once the plan is finalized, we may call on you to help us meet our goals! I hope we can apply Sandy’s lessons and role model to be humble enough to take a learning approach to leadership and tenacious enough to hold steady through ambiguity and change.

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