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


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President's Message: June 2019

Posted By Katharine Hahn Oh, PhD - OPA President, Tuesday, September 3, 2019

We are taught that self-care is an ethical responsibility, but recently the idea of “community care” has become popular. What does it mean to care for each other as colleagues to ensure that we are maintaining our own well-being as we help our clients? In my training with feminist psychologist Dr. Pamela Remer, we were taught to critique notions that are overly individualistic or de-contextualized, and self-care may be one of these. If self-care is meant to help us maintain our well-being, it may be inadequate at times. When we have severe or acute health concerns, have intense care giving roles, or experience grief or depression, self-care is not enough. Rather, we need others to support us. 

Johnson et al. suggest that we develop “competency constellations” to help us stay accountable and well. Their idea is that competency can be reduced at different times throughout our careers as we face health problems, overwhelming stressors, or fail to maintain up-to-date knowledge. If we accept this as normal, then we can talk openly with trusted others about our concerns and let them help us to (a) maintain our competency through additional learning, treatment, or expert support, or (b) know when to take a break from our practice for more intensive treatment. 

I have a few people who are part of my own constellation. Across my professional organizations, these are people I call to ask about challenges I’m facing for the first time. As I’ve been leading the OPA Board this year, I’ve asked for feedback about how I’m doing as a leader. At work where I direct our Counseling Center, I get advice and feedback from trusted colleagues and my staff to help improve my work. In the Counseling Center, we recently read Robin DiAngelo’s article on White Fragility, discussed it among White staff and then all together as a diverse group. We agreed to call each other out when we hear a racial microaggression so that we can each improve our own work toward dismantling racism. So in this way we are pushing and supporting each other to enhance our competencies with implicit bias. 

Finally, I have had the privilege to have supervisors who helped me think about my own mental health and how it can be managed while helping others. During my doctoral program, my depression kept me from going to my practicum site a few times: if I couldn’t stop crying to get ready, I didn’t go. With treatment, I was able to work every day and be present with clients. My supervisors helped me explore how the depression impacted my work and how I could increase my treatment to recover from it. After multiple major depressive episodes my psychiatrist recommended staying on medication indefinitely, and colleagues helped me adjust to this reality. Now I see a therapist every two weeks and continue medication. I’ve been depression-free for four years, the longest in my adult life! As I’ve supervised practicum counselors and interns over the years, a number of them have let me know about their own depression or anxiety symptoms. We are not immune to mental health concerns because we practice in the field, but we can support each other and make it okay to talk about. 

OPA is an organization that cares about us as people. The Colleague Assistance Program is one way to connect with others for support. As I’ve been involved with OPA, I’ve met mentors and friends who are part of my trusted community. Whether your community is with colleagues or family and friends, I hope you have a constellation of people looking out for you as you do the important work of healing, teaching, consulting, or researching. 

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President's Message: May 2019

Posted By Katharine Hahn Oh, PhD - OPA President, Thursday, May 30, 2019

How do we begin to make an impact on state legislation that impacts our practice, our clients, and the public? Two easy ways to make a difference are to 1) give to the PAC, and 2) get to know your own legislators. OPA’s Political Action Committee (PAC) collects donations and then supports legislators who can help improve access to care, reduce violence, and improve educational opportunities. So far in 2019, we have provided funding to several legislators by giving to their campaigns. Usually, we also then have time with the candidate at a fundraising event. These contacts help us to form relationships and provide needed information that can inform their committee work as policies and laws are shaped. 

We are able to give about $500 to each candidate. Over the course of a year, we typically receive about $10,000 in donations which are then given to candidates. In contrast to these numbers, other health professions have much more robust Political Action Committees, sometimes giving $10,000 to each candidate with over $100,000 annually to spend. Ohio is not unique in this regard. Psychologists give less to PACs than psychiatrists, physicians, and social workers. I wonder if we are less aware of how interconnected we are with those making laws and shaping policies? Or if we think we are somehow getting our hands dirty by contributing to politicians’ campaign funds. What might prevent you from giving to our PAC? 

Both OPA and APA give in a bipartisan manner, seeking out legislators who care about health care and the social determinants of health. Here are some of the legislators the OPA PAC has given to so far this year (with relevant quotes from their official online bios): 

  • Rep. Beth Liston of Dublin is a physician and faculty at OSU. “A passionate advocate for affordable, high quality healthcare, State Rep. Beth Liston ran for office to bring her knowledge about health and the health impacts of policy to our state government.”
  • Rep. Derrick Merrin represents portions of Fulton and Lucas counties. “As Chairman of Health Committee, he has advocated for policies to reduce health care costs, promote price transparency, and better patient access.”
  • Rep. Bill Seitz is from Cincinnati. “Throughout his legislative career, Rep. Seitz has been at the forefront of criminal and civil justice issues, leading the effort to reform Ohio’s criminal sentencing laws and eliminate the barriers to employment many nonviolence offenders face following their release from prison.”
  • Senator Kenny Yuko is from Cuyahoga and Lake Counties. He previously served as a Representative. “Yuko ran for State Representative in 2004 with the goals of protecting working families, promoting health care access, and improving Ohio’s economic climate. Served on the Committee on Health and Aging and the Committee on Veterans Affairs.”
  • Senator Cecil Thomas of Cincinnati previously served on Cincinnati’s City Council. “His most notable success is the Cincinnati Initiative to Reduce Violence (CIRV). This program provided direct resources and outreach services to at risk youth/young adults in Cincinnati’s most troubled neighborhoods addressing the critical problem of violence and crime. The implementation of the CIRV program resulted in a significant reduction of crime and improved community and police relations to which is now being modeled nationally and internationally.” He currently serves on the Education, Civil Justice, and Insurance Committees. 

So, I want to encourage you to give to the PAC. Even $20 can make a difference in communicating that we care about these issues. 

What are your own legislators doing about issues you care about? Check out their bios and view these Tips for Effective Communication with Legislators! Our Advocacy Committee, led by Dr. Brad Potts, has created these great resources for finding out who your legislators are, establishing a relationship, writing a letter, etc. The first step is just learning about them, and the next step is reaching out. This fall, OPA will have a Legislative Day at the Capitol when you can learn more about how to advocate with your legislators, then visit their offices and attend a social hour. But I encourage you not to wait but to become an active citizen now. 

A third strategy for making a difference would be to run for office yourself! I had the pleasure of seeing Dr. Amber Hewitt recently. She was faculty at U of Akron, then had a year-long legislative fellowship through APA and is now looking to run for office herself in the D.C. area. What could we do if we had more psychologists in the State House here in Ohio? One of the goals for our Strategic Plan is to get more psychologists involved in committees or task forces for the state. If you are currently serving on a task force or committee for the state government or if you are serving in a public office (City Council, etc.), please let me know so that we can reach out to you and help others get involved too! You can email me at: k.j.hahn@csuohio.edu

I look forward to seeing what more we can do for psychology and the public as we contribute, reach out to our legislators, or run for office ourselves! 

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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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