Click here to review the AI Guidelines developed by OPA's Communications and Technology Committee.

The Neuropsychology Committee is one of the OPA’s newest committees, established just over one year ago. Our committee members include both adult and pediatric neuropsychologists representing a variety of professional settings, including academic medical centers, community hospitals, the VA, and private practices. Members span multiple stages of professional development, from postdoctoral fellows to mid-career clinicians. This breadth of experience and perspective strengthens our collective ability to promote and advance neuropsychological practice throughout the state of Ohio.

Broadly speaking, the primary goal of the committee is to advocate for the interests of neuropsychologists and the patients we serve within OPA and at the state level. To that end, we have been working on important billing-related topics, such as Medicaid coverage for technician codes and billing procedures for trainees. We also aim to increase awareness among other health professionals and the public about the field of neuropsychology while also fostering greater connection and collaboration among neuropsychologists in the state. Committee members served as judges for Ohio Science Day projects and have organized bi-annual networking events, including social gatherings designed to strengthen professional relationships among colleagues and trainees.  We also recently welcomed our first trainee member, helping to increase representation and mentorship opportunities for emerging professionals in our field. In the upcoming year, we will be developing a neuropsychology-focused episode of Meet Maria (Meet Maria - Ohio Psychological Association), designed to educate students who may be interested in pursuing a career in neuropsychology. We are also exploring the creation of a webinar or continuing education workshop for primary care providers, aimed at improving understanding of neuropsychological services, clarifying referral processes, and enhancing interdisciplinary collaboration. 

If you are interested in learning more about neuropsychology, there are a variety of resources available to families and professionals. Those seeking to connect with a neuropsychologist can refer to online directories, such as the OPA Find a Psychologist directory (Ohio Psychological Association) or the search tool on the American Academy of Clinical Neuropsychology website. We also encourage professional colleagues and trainees interested in learning more about neuropsychology to explore resources offered through APA Division 40 and other neuropsychological organizations (e.g., scn40.org; theaacn.org, https://www.nanonline.org), which provide valuable information about training, practice standards, and professional development opportunities.

While the DSM-5 remains the dominant system for classifying mental health disorders,
psychologists may not always be aware that several alternative diagnostic models have been
developed—and are worth serious consideration. Though none of these systems has been
formally adopted by the broader clinical community, their existence points to ongoing efforts to address some of the significant limitations of the DSM approach.

Even the authors of the DSM-5 acknowledge its constraints, particularly its reliance on
categorical definitions of mental disorders. Categorical systems classify individuals as either
having or not having a disorder based on whether they meet a specific number of criteria.
However, this approach often fails to capture the complexity and variability of human
psychological functioning. Many alternative systems propose dimensional models, which
conceptualize psychological symptoms on a continuum, emphasizing degree rather than presence or absence. This dimensional perspective can better reflect the nuances of clinical presentation and guide more individualized treatment planning.

Among the most developed alternatives is the Psychodynamic Diagnostic Manual (PDM-2),
which applies a dimensional framework rooted in psychodynamic theory. It considers personality patterns, mental functioning, and symptom experience across multiple axes, providing a richer clinical portrait that extends beyond symptom checklists. Another alternative is the Research Domain Criteria (RDoC) initiative developed by the National Institute of Mental Health.  This focuses on underlying behavioral and neurobiological processes across domains such as cognition, affect, and arousal. Though currently used primarily in research contexts, RDoC has been proposed as a future framework for clinical diagnosis—particularly one that aligns more closely with a behavioral science perspective.

Importantly, these alternatives are not replacements for the DSM-5, nor are they without their own limitations. But their emergence signals an important shift in the field: recognition that diagnostic classification must evolve to better reflect empirical evidence and the lived experiences of clients. The DSM itself has opened the door to future models that may integrate categorical and dimensional approaches, moving toward diagnostic systems that are both more scientifically grounded and more clinically useful.

As psychologists, staying informed about these developments helps us remain critical of the tools we use, thoughtful in our case conceptualization, and open to innovations that may ultimately improve the quality of care we provide.

As therapists, we know that the work clients do between sessions is often the most important part of the change process. But clients do not always realize this. Many arrive expecting that simply talking about their problems once a week will be enough. Our job, in part, is to help shift that expectation and support them in actually using what they learn.
 
Therapy is a lot like teaching someone to play the piano. The lesson matters, but progress depends on what happens in the hours that follow. When clients treat therapy like a weekly lesson and practice what they learn in real life, they tend to improve. When they do not, things usually stall.
 
A recent study by Hernandez Hernandez & Waller (2021) found that clients who use therapy tools outside of session are more likely to make meaningful changes. But it also highlighted a common disconnect: therapists tend to emphasize the value of between-session work more than clients do. This is where our clinical approach can make a difference.
 
Here are several strategies that can help increase follow-through and improve client outcomes:

• Set clear expectations from the start. Clients benefit from knowing early on that therapy will require active work between sessions. Setting that frame at intake—and reinforcing it regularly—can help prevent misunderstandings and increase motivation.
   
  
• Emphasize collaboration, not compliance. Assignments are more effective when clients feel like they are participating in a joint effort rather than being told what to do. Framing homework as an experiment they are helping design makes it easier for them to stay engaged.
   
  
• Make it personal. Clients are more likely to try something if they understand why it matters to them. Explaining how a specific tool or exercise fits their goals can make a generic handout feel more meaningful.
   
  
• Practice skills during sessions. Rehearsal builds confidence. Clients are more likely to use a new approach on their own if they have already tried it in session and know what it feels like.
   
  
• Anticipate barriers and plan around them. Avoidance, uncertainty, and emotional discomfort often interfere with follow-through. When we take the time to talk through what might get in the way, clients are better equipped to push through those moments.

 
Many of us were trained to create structured treatment plans and to assign homework thoughtfully. But following through on these basics remains essential. When clients understand the rationale, feel involved in the process, and see how the work fits their own goals, they are far more likely to make use of the therapy outside the room.
 
This is where lasting change begins.
 

REFERENCE:
 
Hernandez Hernandez, M. E., & Waller, G. (2021). Are we on the same page? A comparison of patients’ and clinicians’ opinions about the importance of CBT techniques. Cognitive Behaviour Therapy, 50(6), 439-451.

Cognitive-behavioral therapy (CBT) is widely recognized for its empirical support. Thousands of studies each year validate its effectiveness in treating a broad range of psychological conditions. Its structured, time-limited nature makes it a favored approach in clinical research and practice. However, many practicing therapists have noted that clients often come to therapy with needs that go beyond what standard CBT protocols are designed to address.

One area where this is especially evident is in the realm of existential concerns—questions about meaning, purpose, identity, and mortality. Clients often bring to therapy a desire to understand what their lives mean, what values should guide them, or how to make peace with the limits of their time on Earth. These are not problems that always lend themselves to brief interventions or manualized treatment protocols. Yet they are deeply human and therapeutically essential.

Recent scholarship suggests that CBT can be expanded to incorporate these deeper existential themes. For example, Heidenreich and colleagues (2021) argue that CBT’s focus on cognition aligns well with existential therapy’s emphasis on meaning-making. Likewise, research by Olstad et al (2022) highlights how therapists can effectively explore meaning in life, particularly with adolescents coping with trauma, by blending existential inquiry with cognitive-behavioral techniques.

In clinical practice, approaches like Acceptance and Commitment Therapy (ACT)—a form of CBT—have already started to move in this direction by emphasizing personal values. However, as the uploaded commentary notes, even ACT may fall short in helping clients deeply explore and define those values when they are grounded in life’s larger philosophical questions. What is the purpose of life? What makes life meaningful? These questions are more than abstract—they often surface in sessions when clients reflect on identity, loss, or the passage of time.

Far from being incompatible, CBT and existential therapy can complement each other. CBT provides structure and evidence-based strategies for change, while existential therapy offers a framework for grappling with life’s most profound dilemmas. Ghaemi (2023) underscores that addressing existential issues—such as death, freedom, and isolation—can enrich any therapeutic approach. In palliative care, as noted by Breitbart et al (2012), existential-CBT interventions help clients face mortality with dignity and insight, demonstrating the clinical value of this integrative approach.

Therapists do not have to choose between addressing symptoms and addressing deeper aspects of the human individual. When CBT is practiced flexibly and creatively, it becomes a vehicle for helping clients do both. In fact, this integration may be one of the most promising directions for psychotherapy in the coming years.


REFERENCES
Breitbart, W., Poppito, S., Rosenfeld, B., Vickers, A. J., Li, Y., Abbey, J. & Cassileth, B. R. (2012). Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. Journal of clinical oncology, 30(12), 1304-1309.

Ghaemi, S. N. (2023). In the tradition of William Osler: a new biohumanistic model of psychiatry. Perspectives in biology and medicine, 66(4), 520-534.

Heidenreich, T., Noyon, A., Worrell, M., & Menzies, R. (2021). Existential approaches and cognitive behavior therapy: Challenges and potential. International journal of cognitive therapy, 14(1), 209-234.

Olstad, K., Lien, L., Leonhardt, M., Sørensen, T., & Danbolt, L. J. (2022). Therapists and the Topic of Meaning in Life in Their Encounters With Adolescents With Developmental Trauma: A Qualitative Study. Frontiers in psychiatry, 13, 835491.

We also continue to provide continuing education workshops to members.  We held a virtual workshop again in May 2025 as part of OPA’s convention.  Part of the focus of that workshop was on ethical issues related to Artificial Intelligence (AI) and we received positive feedback that this was an area members were happy to spend more time thinking about and discussing.
We recently added an Early Career Psychologist to the committee, Dr. Amy White.  If you are interested in joining the ethics committee, please fill out an interest survey on the website.

In the second half of 2025, CTC plans to begin developing Season 4 of Maria (where is she headed??).  

If anyone would like to join CTC, contribute to the Meet Maria project, or post information on the blog, just email me and let me know.

Over the past few years, the Surgeon General has released health advisories related to social media use on youth’s mental health. A plethora of social media research has indicated that those who use social media more may face more mental health concerns (anxiety, depression, low self-esteem, etc.) due to the amount of exposure to harmful content such as cyberbullying, social comparison, body shaming, exploitation and harassment. According to research from Pew Research conducted in 2022, nearly half of teens have experienced cyberbullying (https://www.pewresearch.org/internet/2022/12/15/teens-and-cyberbullying-2022/ ). Research also indicates that the type of engagement matters too. Social media users who are actively engaged (i.e. posting comments) are more likely to benefit from social media; whereas those who are passively engaged (i.e. browsing) find social media more harmful. What can caregivers, mental health professionals, government officials, and concerned parties do to support youth’s mental health and their social media behaviors when social media access can be constant and hard to regulate use or content for which youth are exposed?

An increase in social media laws have been drafted and passed in hopes of regulating social media use in youth. Some of these acts are targeting banning addictive algorithms to decrease addiction to social media, and other forms of legislation are targeting increasing parental permission and decreasing social media use in youth. Many of these bills have been blocked because they violate youth’s rights, such as freedom of speech. One such legislation includes the Ohio’s Social Media Parental Notification Act (https://codes.ohio.gov/ohio-revised-code/section-1349.09 ).

The Ohio Social Media Parental Notification Act passed in 2023 and was scheduled to go in effect in January 2024. This act enforces parental permission for social media use and online gaming for children under the age of 16 years old. The legislation requires social media companies to enforce users under 16 to have caregivers consent to their child’s social media use, and to do so the caregiver must provide a form of ID (via telephone, video conference, or an online system). Early in 2024, a judge blocked the law from taking effect due to NetChoice (a trade association that has represented social media companies to protect freedom of speech) filing a federal lawsuit in January 2024 against Ohio because of this social media act (https://netchoice.org/netchoice-v-yost/ ). NetChoice is suing due to the legislation violating First Amendment rights. The Supreme Court has indicated in previous rulings that placing the government in charge of what youth can and cannot see online is against people’s rights. NetChoice indicates that this bill infringes upon privacy rights due to the act requiring identification and a way to monitor age. Ultimately, NetChoice indicates that social media companies already have protections in place with parental controls and monitoring, and age restrictions for certain social media content or activities for minors under 13. However, if social media companies already have sufficient protections in place for youth, as indicated by NetChoice, then why do youth still face harms on social media? It seems like more avenues and questions need to be explored and answered; however, legislators have reached a standstill. 

Legislators need to further explore how to support youth’s social media use and mental wellbeing. One of the biggest concerns social media companies pose regarding regulations is related to protecting freedom of speech. So, I ask how one can protect youth’s freedom of speech while also protecting their mental health when youth use social media and at what point does mental health trump freedom of speech?

Do these regulations and restrictions target the most harmful aspects of social media? One of the most prominent, harmful behaviors displayed on social media is social comparison behaviors. How does one restrict, monitor or regulate an implicit behavior?  Additionally, many protections place the responsibility on caregivers to enforce restrictions on their children. According to Pew Research, about 60% of teens state that their parents are providing good support regarding social media use; however, 74-81% of teens indicate that social media sites and elected officials are not doing a good job addressing related concerns about social media (https://www.pewresearch.org/short-reads/2023/04/24/teens-and-social-media-key-findings-from-pew-research-center-surveys/ ). So, maybe, others involved in youth’s exposure to social media may need to be targeted as well.

Finally, how have past commercial regulations helped increase the public’s wellbeing? Research has indicated that regulating access to substances decreases harm as there is less exposure or it is harder to be exposed to substances. This can be further demonstrated by the growing health crisis in Portland, Oregon after possession of small amounts of drugs are decriminalized and this has increased accessibility in the city and increased the mental health crisis and substance use rates. One future development proposed by The Surgeon General included adding warning labels that appear on social media sites. These warning labels would be similar to warning labels on cigarettes, which are known to increase awareness and change behaviors. 

Overall, what can mental health professionals do to support healthy social media behaviors in children and adolescents? Mental health professionals can perform one of our most common behaviors which is providing psychoeducation about healthy and unhealthy social media use and increasing social media literacy. I would suggest looking at the following resources on APA: https://www.apa.org/topics/social-media-internet. Caregivers can use a family media plan and can create one on the following site: https://www.apa.org/topics/social-media-internet. Media plans can promote healthy social engagement and can decrease exposure to possible harmful content. Additionally, StopBullying.gov (https://www.stopbullying.gov/ ) provides resources to support youth who experience cyberbullying.

Further resources

• https://governor.ohio.gov/media/news-and-media/governor-dewine-lt-governor-husted-release-statements-following-court-decision-that-temporarily-blocks-social-media-parental-notification-act 
  
• https://netchoice.org/netchoice-v-yost/ 
  
• https://www.missingkids.org/netsmartz/home 
  
• https://www.hhs.gov/surgeongeneral/priorities/youth-mental-health/social-media/index.html
  
• https://www.wiredhuman.org/
  
• https://www.logoffmovement.org/

Dayton Area Psychological Association (DAPA): https://www.daytonpsych.org 

• Contact Dr. Lauren Kaplan for additional DAPA information 
• The group will be supporting the Dayton Autism Society by participating in the 2024 In-Person and Virtual 5KWalk/Run 
  •  April 27, 2024.  at Island Metropark
• Upcoming event: “Equity and Fairness in Romantic Relationships: Exploring the Impact of Mental Load” with Carly Deremo, PsyD
  • June 14, 2024 from 1:00-4:00pm ONLINE
    

Northwest Ohio Psychological Association (NOPA):  https://www.facebook.com/profile.php?id=61550766064026 

• Contact Dr. Mark Babula for additional NOPA information
• Upcoming event: Working with Substance Abuse Working with Families
  • May 17, 2024 from 9:00a-12:15p (offering MCE credits)

Akron Area Professional Psychologists (AAPP): https://www.akronareaprofessionalpsychologists.org/ 

• Contact Dr. Isaac Weaver for additional AAPP information
  

Cleveland Psychological Association (CPA): https://clevelandpsychology.org/  

• Contact Dr. Mackenzie Keriazes for additional CPA information
  

Cincinnati Academy of Professional Psychology (CAPP): https://cappnet.org/

• Contact Dr. Helmer Figueiredo for additional CAPP information

• Cleveland Psychological Association (CPA): https://clevelandpsychology.org/  
  
  • Contact Dr. Mackenzie Keriazes for additional CPA information
    
  • Upcoming event: “Decoding Depression” on November 13, 2023 from 6:30p-8:30p (located at Shaker Heights Public Library offering 1.5 CEs)
    
    
• Dayton Area Psychological Association (DAPA): https://www.daytonpsych.org 
  
  • Contact Dr. Lauren Kaplan for additional DAPA information 
    
    
• Cincinnati Academy of Professional Psychology (CAPP): https://cappnet.org/
  
  • Contact Dr. Helmer Figueiredo for additional CAPP information
    
    
• Northwest Ohio Psychological Association (NOPA):  https://www.facebook.com/profile.php?id=61550766064026 
  
  • Contact Dr. Mark Babula for additional NOPA information
    
  • Upcoming event: “Ethics and Law for Ohio Psychologists: Common and Emerging Areas of Focus” on November 17, 2023 from 9:00a-1:15p (ONLINE and offering 4 ethics credits)

• Akron Area Professional Psychologists (AAPP): https://www.akronareaprofessionalpsychologists.org/ 
  
  • Contact Dr. Isaac Weaver for additional AAPP information
    
  • Upcoming event: “Discussing Dreams in Psychotherapy” December 1, 2023 from 12:00pm-1:00pm (ONLINE and offering 1 CE)

Dr. Erica Birkley

Resources:
American Board of Police and Public Safety Psychology (ABPPSP)
Police and Public Safety Continuing Education
Tri-State First Responder Peer Support
Fitness for Duty Evaluations
988 Suicide and Crisis Lifeline
Suicide Prevention Resource Center

1. The person conducting the research must be a paid member of OPA (or their respective state association).
   
2. OPA requires that the person conducting the research send proof of Institutional Review Board (IRB) approval.
   
3. The name and contact information for the research advisor must be provided to OPA in advance.
   
4. A copy of the survey must be provided to OPA.

When these materials have been provided to OPA, the packet is reviewed by the Science and Research Committee.  Once approved, OPA will then post the request directly to the listserv.  

If you or anyone you know is interested in requesting research support from OPA, review each step first and follow the process. Please do not post directly onto the listserv, which is against listserv guidelines.  Click here for additional information.

Written by: Christine Muller-Held, PsyD, Chair of the OPA Ethics Committee

The practice of psychology is often deeply rewarding. Regardless of the specific area of practice, many psychologists share a desire to help people, organizations, or society. Whether it takes the form of clinical care, teaching, supervision, consultation, research, advocacy, policy development, or other roles in a wide range of settings, that desire to help can also be the driving force that leads psychologists ethically astray. One decision can quickly lead to another, landing even the most seasoned psychologist in an ethical quandary. 

The OPA Ethics Committee serves multiple functions to OPA and its members, among them: “To advance the knowledge and competency of OPA members regarding ethical standards for psychologists; to educate psychologists regarding ethical principles and conduct; [and] to provide guidance to OPA members who have questions regarding their own professional ethics or conduct…” (https://ohpsych.org/page/EthicsCom). To fulfill these functions and provide service to the OPA community, the Ethics Committee provides free, private, confidential consultations to OPA members and student affiliates. 

Many first-time callers or e-mailers may be unsure of what to expect from the process, or that it’s more than a single contact with a quick answer. Initiating a consultation with one committee member triggers a cascade of events that culminates with verbal feedback and recommendations from the committee to the caller. The steps of this process are captured below so that callers know what to expect when they reach out:

• Sign into your OPA member account and visit https://ohpsych.org/page/ethicsconsult to see instructions for the consultation process and members who are available to take your consult. Please note that early career psychologist members of the committee are not listed to take consults, but will participate in the workshopping of the question.
  
• Contact an OPA member by phone or e-mail and share with us your hypothetical concerns, scenarios, or questions. It is critical for consultees to frame their consultation scenario or questions hypothetically and to protect patient privacy and confidentiality at all times. Please note members need only to reach out to one committee member and should not reach out to multiple committee members with the same consult question. All consults are workshopped as a full committee and contacting multiple committee members with the same question will not result in different feedback, and may create confusion. 
  
• Callers will receive an e-mail or call back to gather more information about the questions or ethical dilemma.
  
• The ethics committee member fielding the call will draft caller questions into a vignette or questions to be addressed. This information will be shared with committee members to begin the workshop process. Caller name and contact information is kept private and not attached to the information shared with the whole committee. 
  
• Once many or all of the committee members have weighed in on the vignette’s ethical considerations, the original committee point of contact will reach out to the caller and provide verbal feedback about committee impressions. The ethics committee is not permitted to provide written feedback to callers about their consults. 
  
• At the conclusion of every consult, the written vignette is finalized including any changes that occurred during the process of the consult and archived. The caller’s identity is not attached to the final consult in any way. 
  
  

As stated above, it is critical that callers frame their consultation questions or scenarios hypothetically. This allows the committee to engage thoroughly and sensitively in consultation process, without triggering mandated reporting obligations. The committee’s goal is to assist callers and help them avoid trouble, not to be the “ethics police.”  

Although many questions may seem straightforward, they often are not, and benefit from the committee’s workshop process. Committee members represent various clinical and professional backgrounds, the diversity of which can allow any single consult to be viewed from various different perspectives. It is also true that any given scenario is likely to include ethical, legal, risk management and clinical aspects. The OPA Ethics Committee is only able to provide specific feedback on the ethical considerations of the consults we receive. As a result, callers are often advised throughout the process and in their feedback to consider additional consultation with lawyers, their professional liability insurance carrier, and trusted colleagues. While the committee may identify relevant state laws that connect with the consultation, the committee cannot interpret those laws or venture to guess how the Ohio Board of Psychology would apply those laws in any specific circumstance.

Regardless of a psychologist’s years of experience, practice type, or areas of expertise, all psychologists confront ethical issues in practice on an ongoing basis. As OPA members, please keep in mind the services offered by your OPA Ethics Committee as you engage in your professional practice and please do not hesitate to contact us for a consultation if you feel we can be of assistance.

OPA’s listserv guidelines differentiate between Informal Advertising and Formal Advertising.  Informal Advertising is allowed by all members, while Formal Advertising is not.  Here is how the two are differentiated:

Informal Advertisements (allowed by all members)

• Do not include fliers, websites, links, attachments, or detailed information (just as detailed job posting).   
  
• Are allowed only when the author of the post does not benefit financially.
  
  • The offering of ongoing free services that will not lead to paid services (e.g., ongoing support groups, volunteer experiences) are allowed to be posted for now.
    
• Must ask members to contact the author backchannel for additional information.  
  
• Examples:
  
  • We have an opening for a licensed psychologist who works with children/adolescents in our office in Akron, Ohio. Please contact me backchannel for details  
    
  • We are accepting applications for an outpatient therapist specializing in evidence-based treatment of borderline personality disorder.  Please backchannel for more information.
    

Formal advertisements (only allowed through OPA)

• Do include fliers, websites, links, attachments, or detailed information about the location, job description or tasks, benefits, application process, etc.  
  
• Examples:
  
  • Providing any detailed information listed above.
    
  • Copying and pasting published job postings from any company.
    
  • Providing links to the company, location, or website for applying (e.g., Indeed.com).
    
• OPA does allow members to formally advertise: however, there is a process to follow.  If you would like to use the listserv for formal advertising, here is how:
  
  • All job postings must be sent to the OPA Career Center
    
  • All continuing education opportunities must be sent to OPA Educational Opportunities  
    
  • All other advertising (e.g., office space or items for sale must go to the Classified Ads section
    

I hope this information and these examples help clarify what is and is not considered to be appropriate listserv activity. We understand advertising is very important to all businesses and organizations, but we want to keep this Listserv a supportive, light, and ad-free zone.  If you have any questions about advertising or would like feedback before posting, feel free to email me.  

Keeping up to date with peer-reviewed professional journal publications is a challenge for many psychologists. Depending upon your personal areas of interest, the number of journals and relevant articles may be overwhelming and maintaining subscriptions expensive. Without university library privileges, most psychologists are limited in being able to access current articles or search for past publications. 

Fortunately, there are alternative ways to obtain access to past and current professional journal articles at minimal or no cost. The first steps are to decide what topics or interest areas you want to keep informed about and what journals publish content about it. Next, go to the journal‘s website. Most journals have an option to register to receive email alert when articles are published (often online first) and the table of contents when journal issues are published. Indicate wanting to receive either or both types of alerts. For psychologists interested in American Psychological Association affiliated journals, this can be easily be done by going to https://www.apa.org/pubs/journals/browse?query=Title:*&type=journal.

Some journals publish open access articles (sometimes for time limited periods) and these can be downloaded directly from the journal’s website. An alternative way to get a published article without a journal subscription is to email the article’s corresponding author requesting a copy (their email is often included in posted abstracts or it may be found if they list an affiliation where they have a posted email address). 

Another way to learn about recently published articles is to create a free account at specialized websites that will allow you to create individualized filters for authors and keywords. The website will then send you periodic alerts when articles matching the terms are found. The following are examples of some of these types of web sites: 

• Researcher (https://www.researcher-app.com/) is free and available in Windows format and for Android (https://play.google.com/store/apps/details?id=io.fusetech.stackademia&hl=en_US&gl=US) and iOS (https://apps.apple.com/app/id1249306392?mt=8). Alerts may be limited to abstracts but if your institution subscribes to the journal you can access pdf full text versions of articles. 
  
• Google Scholar (https://scholar.google.com/) is a free web search engine that indexes journals, books, conference papers, preprints and abstracts. It also can be set up to provide for email alerts for keywords (e.g. author names, topics). If full text pdf versions are available for downloading that will be noted. 
  
• PubMed (https://pubmed.ncbi.nlm.nih.gov/)is a popular literature search site. Although PubMed does not provide for creating publication alerts, it provides free access to article abstracts and sometimes includes full text journal article, links to the full text when available from other sources, such as the publisher's website. An Android mobile app version of PubMed, Prime: PubMed Journals & Tools, https://play.google.com/store/apps/details?id=com.unbound.android.medl&hl=en_US&gl=US  is a convenient way to access and use PubMed via a smartphone. 
  
• ResearchGate (https://www.researchgate.net/) is another free resource for getting alerts about new articles and obtaining article copies. It is an academic social network where researchers share papers and articles. 
  
• Academia.edu (https://www.academia.edu/) is academic social network produced by a for-profit company that offers both a free basic and a pay premium version to searching for full text professional journal articles and for creating article publication alerts. 
  

In addition to obtaining copyrighted published articles mentioned above, many open access articles can be found at no cost at online open access repositories such as OpenAIRE (https://explore.openaire.eu/) and DOAJ (Directory of Open Access Journals) (https://doaj.org/).

• Why Your Uncle Isn’t Going to Get Vaccinated – By Stuart Vyse
• Under the Cortex:  Why Some People Won’t Get Vaccinated
• COVID 19 Vaccine Hesitancy: 12 Things You Need to Know – From John Hopkins

• Either a) to have a doctoral degree in psychology from an APA/CPA accredited program, one that was designated as a psychology program by the ASPPB/National Register Joint Designation Committee at the time of conferral of the degree, or b) a program deemed equivalent by a recognized foreign credential evaluation service. 
• Send transcripts from the institution granting the doctoral degree to ASPPB.
• To have passed the Examination for Professional Practice (EPPP) with a score that meets or exceeds the ASPPB recommended passing score at the time of application. 
• To pay an E.Passport application fee of $400 and a one time APIT fee of $40.
• For annual renewal: to pay a $100 annual renewal fee and to complete three hours of continuing education relevant to the use of technology in psychology.

Temporary Authorization to Practice (TAP):  This option requires a psychologist to have an Interjurisdictional Practice Certificate (IPC). Applicants for the IPC must: 

• Meet the same degree and transcript requirements listed above for the E.Passport. 
• Pay the IPC application fee of $200 and a one-time TAP fee of $40.
• For annual renewal: pay an annual renewal fee of $40.

Ohio psychologists can begin applying for the E.Passport to gain authority to practice telepsychology and/or IPC for temporary authorization to practice (TAP) on August 3, when our law becomes active. The PSYPACT website states:

In order to apply, you will need to either create an account in PSY|PRO, ASPPB’s credentials management system (www.psypro.org) or log into an existing account. Once logged in, look to your right panel. There will be a section called Select an Activity. You will want to select Practice Telepsychology under PSYPACT if you want to apply to practice telepsychology and/or select Practice Temporarily under PSYPACT if you want to apply to conduct temporary in-person, face-to-face practice. This will allow you to initiate an application and pay. Your application checklist for the E.Passport and/or the IPC will appear on your Home page in your Activity Summary section. Select “Edit” to access the checklist and complete the required sections. (https://www.asppb.net/page/telepsychology )

Although PSYPACT expands opportunities for psychologists and clients, there are limitations and cautions to be considered. For approval, applicants must not have any disciplinary action listed on any psychology license. They must also have a full, unrestricted license to practice in a state that has joined PSYPACT, such as Ohio. To maintain an E.Passport, annual continuing education is required related to the use of technology. Psychologists practicing through PSYPACT are subject to the laws, rules, and scope of practice of the state into which they are practicing, either temporarily or remotely. PSYPACT does not apply when both the psychologist and client are in states in which the psychologist is fully licensed as a psychologist. Although the use of technology can promote continuity of care as clients move between PSYPACT states, use of the E.Passport requires the psychologist to be in a PSYPACT state in which they are licensed.

Additional information can be found at https://psypact.site-ym.com/. OPA has provided resources and information related to PSYPACT historically, and plans to continue to do so in the future. Additional resources may include the OPA Communications and Technology Committee (CTC), the Ohio Board of Psychology, the Association of State and Provincial Psychology Boards (ASPPB), as well as the boards of other jurisdictions and telepsychology organizations.

Disclaimer: This post is for informational purposes only and it is intended to assist other clinicians in the practice of psychology.  It is not an advertisement nor intended to be used for legal, ethical, clinical, or medical advice.

The Committee Spotlight series was introduced at the beginning of the biennium with the goal to introduce OPA members to individual groups, committees, subcommittees, and task forces within the organization. We hope to inform OPA members of these groups that can be utilized as resources for so many different purposes. If you have ever thought to become more involved in OPA or professional development in general, committee work is the perfect place to begin. A complete list of committees, subcommittees, task forces, and affiliates can be found here. Some groups may be seeking new membership, leaderships roles, or volunteers for projects. Commitment levels often vary and depend on the specific group and member availability.

I am very excited to introduce Dr. Leslie McClure from the Insurance Committee as the second Committee Spotlight of 2021!  

We enjoy providing training on topics such as documentation requirements, chart audits, CPT codes, and communicating with insurance companies. Pre-recorded webinars can be found on the OPA CE Opportunities webpage. You can also find resources such as our Audit Toolkit and important links for regulatory agencies on our Insurance Committee webpage.  We also like to be active on the OPA Listserv to stay informed of issues that members are having and to point members to available resources and information. 

Some recent issues we have addressed include dispelling the various myths related to telehealth coverage changes, addressing the confusing insurance company letters on appropriate use of CPT code 90837, and helping OPA members with delayed panel credentialing. 

We work closely with OPA’s Director of Professional Affairs, Jim Broyles. Dr. Broyles has fostered relationships with directors at many third-party payors and he has an understanding of the regulatory agencies involved with insurance issues in the State of Ohio. His knowledge and direct connections can often lead to better clarity and faster resolution. 

Third party payors impact access to care for Ohio’s citizens and impact the economic livelihood, directly and indirectly, for many of Ohio’s psychologists. The Insurance Committee is always searching for new members who are passionate about these issues. Committee members tend to be involved in private practice but psychologists from other settings are strongly encouraged to add their voice to this arena. For questions about how to become involved with the committee please contact Leslie McClure. We always welcome general questions, ideas, and comments as well. 

The Committee Spotlight series was introduced at the beginning of the biennium with the goal of introducing OPA members to individual groups, committees, subcommittees, and task forces within the organization. We hope to inform OPA members of these groups that can be utilized as resources for so many different purposes. If you have ever thought to become more involved in OPA or professional development in general, committee work is the perfect place to begin. A complete list of committees, subcommittees, task forces, and affiliates can be found here. Some groups may be seeking new membership, leaderships roles, or volunteers for projects. Commitment levels often vary and depend on the specific group and member availability.

Starting the week of March 16, 2020 my professional life changed with the spread of the Covid-19 pandemic and its increasing impact in Ohio.  Having been a psychologist for over thirty years and always having a full schedule of more than thirty clients a week, my schedule of clients went from over thirty clients to ten clients or under a week.  Yes, I was able to talk to clients by phone or use the telehealth component of our Simple Practice platform.  The challenge at that point was that most of my clients required a psychological evaluation.  My own professional work had evolved to the point where more than 66% of my clients required a psychological evaluation.  These clients included those who needed an evaluation for ADHD, pre-surgery bariatric, and memory loss/dementia.  Although I knew I could retire, I still enjoyed the challenges and opportunities of private practice.  Although my professional hours significantly reduced and I was able to take an occasional, unprecedented nap during the day, I knew I wanted to go back to work and planned to go back to in-person work.  Like a good solution-focused psychologist, I began to explore alternatives.  Initially, I considered remote test administration and as Pearson helped to roll out possibilities, I became intrigued.  However, my billing person quickly squelched that idea when she reminded me of how little remote test administration brought in insurance reimbursement.  Then I pondered, how can I go back safely?  I did not entertain not going back to work in-person but how to do it safely.

I immediately ordered clear plexiglass screens that had a base and could sit on a table.  These plexiglass screens had openings at the bottom where test materials could be readily shuttled back and forth between the client and me.  I targeted June 15, 2020 as the return to in-person work, hoping and praying the screens would be there after over a two month wait for them.  Along with the plexiglass screens, I also purchased HEPA air filters for my office and the testing room.  Once returning to work to do psychological evaluations on June 15, 2020 all clients were asked to wear masks in the waiting room and of course, advised not to come if they were sick.  Once behind the plexiglass screens (which did arrive by the June 15 date), I gave them the option of taking their masks off or leaving them on.  I asked them the same permission for myself.  After testing, all pencils/pens/clickers/computer “mouses” were all wiped down with sanitized wipes.  I started back in-person psychotherapy in July 2020 and provided all psychotherapy behind the clear plexiglass screens even at times employing two screens if a couple decided to sit in different areas of the room.  Admittedly, the Covid pandemic has made me more efficient.  Where I used to write my notes down for any initial session, I started to type the notes which was a more efficient use of my time.

On January 15, 2021, as an auxiliary hospital staff member, I received my first dose of the Moderna vaccine and on February 12, 2021 the second dose.  Although I can’t say for sure but I believe the use of the plexiglass and the mask options as discussed above will carry on well into the rest of 2021 and perhaps even beyond.  Of course, there are and will be clients who prefer phone or teletherapy sessions and I am more than willing to accommodate them.  I am thankful that, as a psychologist, I could continue to practice my work even though in an ultimately altered fashion.

Disclaimer: This perspective post illustrates the journey of one psychologist managing the pandemic at work.  It is for informational purposes only and it is not intended for legal, ethical, or medical advice.  

The COVID Vaccine: My experience and Why I think It's Worth it"

I remember, February/March of 2020, listening to the radio and hearing about the outbreak of a SARS-derivative virus. It was advancing rapidly around the globe with one big question: when will a vaccine be available? Numerous infectious disease professionals remarked how unlikely it would be to have one available within the year; many people were dissatisfied with that answer to say the least. Then, Operation Warp Speed: the government devoted personnel and resources to prioritizing the development of a vaccine. Finally, through rigorous science and tireless commitment to the work by the vaccine developers, in December 2020, healthcare professionals, including myself, and citizens at greatest risk, were already being vaccinated! Even though I work in geriatrics, providing in-person care to United States veterans in the VA's nursing home, I am a trainee on my postdoctoral psychology residency and a healthy person in my early 30s, so I never thought I would be so fortunate as to have access to some of the first doses of the vaccine. But while I was excited to do my part to contribute to protecting public and personal health and safety, I was also astounded at the many reports from people who voiced distrust in the vaccine and a reluctance to get vaccinated. What changed? A mere 10-12 months ago, people were demanding one that couldn't come soon enough, but now, once it arrived, people balked at the same speediness they demanded and have adopted a "watch-and-wait" attitude, or worse, one of complete dismissal of the vaccine.  

To mark the recent one-year anniversary of the World Health Organization declaring a global pandemic, I wish to share my personal experience with the vaccine.  It is my belief that a vaccine with some potential uncomfortable side effects is preferable to a COVID infection any day. I was fortunate to be one of the first to get vaccinated with the Pfizer vaccine within days of the Cleveland VA receiving their first shipment. With my first dose, I had no side effects other than mild muscle soreness at the injection site like that which accompanies my annual flu shot. It felt like a historic moment, one in which I felt immense pride, excitement, hope, and gratitude. I was doing my part to help stop the spread of this public health crisis and felt honored to be doing my part as a United States citizen, a healthcare professional, and a neighbor. My second dose was more unpleasant, but brief and nothing compared to what an actual COVID infection would be like. I had injection site soreness, but about 12 hours after the injection, I also experienced some chills/shakes, body aches, fatigue, headache, and chest tightness. These symptoms generally phased in one after the other, and each didn’t last long. The fatigue persisted throughout but each symptom typically resolved after 12 to 24 hours. After just over 48 hours total from the onset of side effects, it was over. Bottom line, I spent my weekend in bed resting and was ready to go Monday morning for work. I’m glad I specifically chose to get vaccinated at the end of the week, just in case I experienced side effects. My recommendation to anyone getting the vaccine, is to plan accordingly. Find a time that works with your schedule to allow you a day or two to recover, if needed, so as to minimize disruptions to your life, work, and responsibilities. Stock up with your go-to cold accoutrements (e.g. Gatorade, soup, crackers), a couple of your favorite movies/shows, a comfy blanket, and most importantly, a positive, gratitude mindset mantra: “I’m playing an important role in ensuring the health and safety of my community; these mild symptoms are nothing compared to an actual viral infection and it’ll be over soon.” 

As someone who works in the hospital and sees the destruction this virus is having on countless lives, I implore the people who adopt an anti-vaccine stance to reconsider. Today and tomorrow, no matter what your stance has been, I want to stand together, united against death and destruction, united in protecting the health and safety of all citizens, and united in the pursuit of a quicker, more efficient vaccine distribution. Today, I say, a vaccine, even one with some side effects, is still unquestionably and unarguably worth it! We must put into perspective the big picture. We must know that no one deserves this virus, and we have to do our part to prevent further infections. We must understand that this is not a matter of opinion, it’s fact; there is a virus, there are solutions-ones we once demanded-and it’s up to us to use them. If we want our “lives” back, then we must preserve lives to begin with. I could not be prouder to do my part, to know that I am helping to stop the spread and helping even just one more person avoid the pain and loss this virus can inflict. Let’s work together to build a safer and healthier nation; join me and so many other brave citizens and healthcare providers in getting this vaccine.

Be sure to read Part 1 of this COVID Vaccination series (titled “Is the vaccine right for you: Facts versus fiction, how to talk to your patients, and where to find resources for more information”) published last week.  

Disclaimer: This perspective post illustrates the journey of one psychologist and it is intended to assist other clinicians in the practice of psychology.  It is for informational purposes only and it is not intended for legal, ethical, or medical advice.  

• What vaccines are currently available?
  • The three vaccines that are currently approved for emergency use by the CDC are the Pfizer-BioNTech (“Pfizer”), the Moderna (“Moderna”), and the Johnson & Johnson/Janssen (“J and J”) vaccines.
  • Fact sheets from the CDC for each of these vaccines are available here: https://www.cdc.gov/vaccines/covid-19/eua/index.html
• Do I need to get a second shot?
  • Second shots are typically scheduled three weeks after the first for the Pfizer-BioNTech and four weeks or later for the Moderna. The Johnson & Johnson/Janssen is a single shot.
• What are common side effects?
  • Side effects are similar for each of the vaccines and include pain at the injection site, fatigue, headache, chills, fever, and nausea. See the CDC website for more information and when to contact your doctor:  https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html
• What is mRNA?
  • The Pfizer and Moderna vaccines both use mRNA or messenger RNA, not live virus in their vaccines. The Mayo Clinic describes mRNA as “a recipe for making spike protein” so your immune system can mount a defense without having to actually be exposed to COVID-19. This means you are not actually exposed to the virus with these vaccines. The article and video from the Mayo Clinic can be found here:  https://www.mayoclinic.org/mrna-vaccines-immunity/vid-20507649#:~:text=mRNA%20is%20like%20a%20little,at%20all%2C%20live%20or%20killed. 
  • Johnson & Johnson is slightly different and uses viral vector technology, which is a modified version of a different virus. More info on how that works here:  https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/viralvector.html 
• How do I know who can get the vaccine?
  • Visit https://gettheshot.coronavirus.ohio.gov/ and answer a few questions to see if you are eligible. At the time of this writing, a good rule of thumb is that people ages 50 and above are eligible to get the vaccine in Ohio. Locations to get the vaccine can also be found on the aforementioned page. 
• Are people who have already had COVID-19 eligible to get vaccinated?  
  • Yep!  But people should wait until they have recovered from their illness. Contact your doctor to discuss this further. 
• How quickly am I “fully protected” after receiving the vaccine?
  • Two weeks after receiving the second Pfizer or Moderna vaccination, or two weeks after receiving the Johnson & Johnson vaccination. 
• Where can I read more for myself to help me make my own decision about what’s right for me?
  • One of my favorite resources is the downloadable COVID 19 toolkit from the American Lung Association called “Power and Immunity.”  It covers numerous questions, religious considerations, and very valid reasons why people of color might be concerned. Find it here:  https://www.lung.org/lung-health-diseases/lung-disease-lookup/covid-19/action-initiative/vaccine-toolkit
  • The CDC has loads of information about how each of the vaccines were developed, what research went into them, side effects, safety, and more:  https://www.cdc.gov/vaccines/covid-19/index.html
  • To find vaccine locations in Ohio, go here:  https://gettheshot.coronavirus.ohio.gov/
  • Want more information about Ohioans who are getting vaccinated?  Go to the dashboard here:  https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards/covid-19-vaccine/covid-19-vaccination-dashboard  At the time of this writing, roughly 20% of adults in Ohio had started their first dose and 11% had completed both doses. This dashboard breaks this info down by a number of different factors for more info. 
• Are the rates of the virus going down in Ohio?  Are things getting better? 
  • Track the infection trends and data for yourself if this is part of your decision making process!  Find that data here:  https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards 

Another major talking point that has come up in my office as vaccine decisions are happening more frequently is the decision by people of color as to whether or not they would like to get the vaccine. If this comes up in your personal or therapeutic space, it is very important to spend a great deal of time discussing it. As you are likely aware, people of color have, both historically and currently, been mistreated by the medical community. Presently, systematic racism is only one small factor in healthcare disparities in our nation and these disparities are playing out in real time during this COVID 19 pandemic. For instance, 34% of deaths related to COVID-19 are among non-Hispanic Black individuals, despite this group accounting for only 12% of the total US population. See more about this data and other important point on racial disparities at the CDC website:  https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/disparities-deaths.html.  

Historically, people of color have been subjected to incredible medical abuses. This may seem unimaginable to us today and thought of as something from the very far removed history, but cases of medical abuse have actually occurred relatively recently. To highlight just two of these cases, the notable Tuskegee Syphilis studies did not end until 1972 (more info here https://www.tuskegee.edu/about-us/centers-of-excellence/bioethics-center/about-the-usphs-syphilis-study) and the family of Henrietta Lacks did not become aware that her famous cancer were being used without their consent until more than 20 years after her death in 1951 (read the book The Immortal Life of Henrietta Lacks by Rebecca Skloot for the full picture of the impact this has had on both medical science and this family). Her cancer cells continue being used for research today. There are numerous other examples that are simply breathtaking in the scope and horror of what one human could to do another. 

The above events have repercussions for all people of color. Firstly, they occurred within the lifetime of many people of color who are now actively deciding if the vaccine is right for them, which may have created suspicion for some. The above events were also crimes that have been perpetrated against community members and others who share so many commonalities with people of color; in many ways they were being specifically targeted. The combination of these factors have created a large amount of mistrust between people of color of the medical community. To not understand the weight, the gravity, and the pain these crimes have caused to millions of Americans and the mistrust is caused towards the medical community would be a serious error. 

In my sessions, many of my patients have been weighing the literal centuries of wrongdoing and mistrust against the very clear knowledge that the pandemic has disproportionately impacted people of color. The higher rates of infection and higher rates of death due to COVID 19 in minority populations lead them to explore whether the vaccine is one tool they have to fight the virus. I view my role in these discussions as creating a safe and open space to validate this very real emotional struggle, validate the pain caused by generations of mistreatment and give them a voice in their healthcare. It is my hope that having a space to explore these emotions will empower them to make the right choice for their bodies, knowing that it is very possible that in the past, their relatives might not have had that choice. I encourage my patients to seek out information to help them make their choice that feels right for them, and to certainly talk to their healthcare providers for any specific medical questions or concerns they might be having. 

“The vaccine” has been on everyone’s mind lately. Fully discussing every aspect of the decision-making process can’t possibly be covered in its entirety within this small space, but I hope this discussion and information is found to be helpful to you as we all continue working with clients. My goal has been to provide a few talking points and ideas of how to cover the COVID vaccine if or when the topic comes up in your therapeutic space. Though the pandemic is exhausting and stressful in so many ways, idea sharing and supporting one another makes it that much more manageable for all. 


Stay tuned for Part 2 of this series next week. 

Disclaimer: This perspective post illustrates the journey of one psychologist and it is intended to assist other clinicians in the practice of psychology. It is for informational purposes only and it is not intended for legal, ethical, or medical advice. 

Inappropriate referral with too many specifics:
I am looking for a child psychologist to work with an 8 year old African American male from Cleveland Heights, Ohio, who is struggling to stay focused at his nearby private elementary school. He also has difficulty during karate classes in the local neighborhood.

More appropriate referral with general information: 
I am looking for a child psychologist to work with a younger child diagnosed with ADHD on the Eastside of Cleveland. Please back channel me for more details.

Inappropriate referral with too many specifics:
I am looking for someone to work with a mother of 7 children in Medina County who is struggling with marital issues related to her husband’s recent infidelity. She is also struggling to manage her youngest child’s behaviors related to a recent diagnosis of Leukemia. 

More appropriate referral with general information: 
I am seeking a psychologist to work with a mother of a large family who needs support managing family relationships. They live in Medina County. Back channel me for more details.

Inappropriate information request with too many details: 
I am seeking advice or resources for working with a 15-year-old female who was a victim of human tracking in Franklin County. She is experiencing nightmares, flashbacks, and panic attacks. 

More appropriate example for information request: 
I am seeking advice or resources for working with a teenage victim or human trafficking. 

Inappropriate information request with too many details: 
My client is a 26 year old male veteran who was diagnosed with Ebola while serving overseas. Though my client thankfully survived and has mostly recovered, he is struggling to deal with the impact on his life. 

More appropriate example for information request:
I would like some information about working with adults experiencing rare medical conditions and associated trauma symptoms. Please back channel me with suggestions or ideas. 

Inappropriate information request with too many details:
My client is a 45 year old African American gay male residing in Vinton county who was recently diagnosed with terminal cancer. He is currently deciding whether or not to come out to his friends and family before he passes.  Please send me any info you have on LGBTQIA support groups in this county or adjacent counties to help my client explore this important decision. 

More appropriate information request:
Seeking LGBTQIA support groups in Southeastern Ohio, or virtual support groups in a greater range of area. Please back channel if you are aware of any in this area. Thank you! 

• Develop peer relationships with local professionals (don’t forget to include this in your informed consent). 
• Develop a consultation group that either takes place in person at a local (yet distanced) location, or through an online platform (again, don’t forget to include this in your informed consent). 
• Consider reconnecting with past professional contacts or classmates from graduate school with whom you have worked well.
• Reach out privately to a consultant or expert in a specific area.
• Take a training or CE to further your knowledge in a specific area. 
• Consider consulting the OPA ethics committee for anything that might be an ethical “gray area.” 

A final word of advice when posting on the OPA listserv is to be as cautious as possible. Our clients seek psychological services because they need help and trust us to assist them while keeping them safe. Breaking client confidentiality accidentally and/or purposely causes harm to the client. It is also unethical. We all need to do the best we can and keep our clients safe by maintaining their confidentiality at all times.*

*Refer to the  APA Code of Ethics for more information on the limits of confidentiality and mandated reporting.

Disclaimer: This post is for informational purposes only and it is intended to assist other clinicians in the practice of psychology. It is not an advertisement nor intended to be used for legal, ethical, clinical, or medical advice.

References
American Psychological Association (APA) (2020). APA Dictionary of Psychology. https://dictionary.apa.org/ 

American Psychological Association (APA) (2008). HIPAA Frequently Asked Questions. https://www.apa.org/science/programs/research/hipaa-faq 

With the anticipation of change and hope, the making of resolutions and goals is very common for this time of year.  Many individuals engage in this activity for self-improvement.  Businesses and organizations do the same to ensure successful direction and movement in the year to come.  Like most other associations, OPA has a plan of its own.  

As you may or may not know, OPA has a Five-Year Strategic Plan that was first put into effect in 2018.  This plan was initially developed to give OPA direction and propel it towards accomplishment of its overarching mission each year.  OPA’s presidential trio, divisions, and committees all use this plan as guidance throughout the year.   

OPA’s Five-Year Strategic Plan has main three priorities that will continue being a focus in 2021, each with a number of objectives within them.  Each priority has its own leader that oversees the priority and manages movement and progress.  Each OPA division and committee takes part in at least one priority and is responsible for implementation of its objectives.  You can view the full plan here.  Brief summaries of each of the priorities are described below:  

Priority #1: Help Bring the Opioid Crisis in Ohio to an End
The plan is to achieve this priority by partnering with other professional associations as well as the Health Policy Institute in Ohio.  There is to be an increase in the number of psychologists providing substance abuse screenings and continuing education opportunities to assist psychologists.  

Priority #2: Support the Development of Professional Psychology in Ohio
Within this priority, the objectives are to provide grants and scholarships, enhance consultation in the areas of ethics, and achieve legislature wins to keep Ohio psychologists competitive.  Other objectives include the advocacy of Ohio psychologists with insurance companies by increasing awareness of how reimbursement rates increase and to establish an interdisciplinary task force that will hold insurance companies accountable.  

Priority #3: Ally with Communities and Systems
This priority involves communication and consultation with a number of psychology advocates to enhance the field in Ohio.  Under this priority, the association hopes to increase opportunities for Ohio psychologists to consult with First Responder groups in a number of areas and to also work with Ohio’s branches of government to further the field of psychology.  Enhancing knowledge of OPA to the public and the role of psychologists is also listed.  Also part of this priority is to support legislative efforts to increase diversity awareness, cultural competency, equity, and non-discrimination.    

OPA’s Five-Year Strategic Plan is the outline that directs the association and there is a process for making revisions, no matter their size.  This plan is currently in the process of being revised to better highlight the focus on diversity.  Although diversity has always been a primary focus of OPA and is associated with each of the three priorities, it was noted at the end of 2020 that the Strategic Plan does not clearly describe this focus using deliberate language.  The goal is to alter the language within each priority to more distinctly illustrate this focus on diversity.

As previously mentioned, each priority has a leader(s) who manages its progress.  Using this Strategic Plan, these individuals take additional time from their lives to help OPA and psychologists and advance the field of psychology in Ohio.  We are so glad to have each of these leaders and we appreciate all the additional work they do.  If you would like to become more involved in OPA’s Strategic Plan or any of the priorities, connect with an OPA committee of your choice.  All committees, task forces, and affiliates can be found here; feel free to connect with any group that fits your interest.

Disclaimer: This post is for informational purposes only.

Another way technology has been helping clinicians is for suicide detection. I had the pleasure of meeting with Marci Campbell, Vice President of Product and Margaret Walsh, Director of Growth at Clarigent Health to learn how they have built a program that uses technology and artificial intelligence to detect potentially suicidal clients. It is difficult to believe this type of service is even possible!  I believe it can be very helpful to many clinicians in the field and look forward to seeing where it will go. 

I now introduce Margaret Walsh from Clarigent, who was kind enough to give a summary of how technology and artificial intelligence can be used for suicide detection. 

Enhancing your listening with smart technology

Beyond telehealth: Technology to play an even larger role in mental health

Technology has improved our lives by giving us an enhanced ability to speak to loved ones, receive information, and discover new ideas and places. Recently, technology has played a critical role in health services, enabling telehealth visits and communication when face to face care is not possible. As technology continues to evolve, it will surely play an even larger role, enhancing mental health professionals’ ability to provide quality care. 

An enhanced ear

We reveal so much about our internal emotional states through speech. Clinicians are trained to empathetically listen to the client’s story and at the same time, to assess and gather insights from the information the client shares – a tall order! Clinicians may feel anxious about whether they are truly catching every meaningful turn of phrase, particularly for the most at-risk clients.
To help empower clinicians, Clarigent Health has designed a solution to enhance clinicians’ listening abilities. Clarigent was formed to bring to market groundbreaking mental health research conducted at Cincinnati Children’s Hospital Medical Center. Building upon more than a decade of clinical research, Clarigent designed an app-based listening support tool called Clairity. Clairity records speech during a therapy or teletherapy session. It then uses artificial intelligence (AI) to analyze the client’s speech. The algorithms are trained to detect suicide risk and other mental health concerns from speech. For mental health professionals, whose observations are informed by education, practice, and experience, Clairity is designed to provide an additional objective metric to help identify potential risks.

The AI is trained to calculate, measure, and detect subtle features of speech that we call vocal biomarkers of risk. These subtle signals are based on complex calculations and provide noninvasive, objective indicators of mental health states. 

Bringing it all together

No single data point from a single day can paint a complete picture of a complex human being. That is why the Clairity biomarkers are tracked over time alongside patient-reported symptoms (recorded via standard assessments such as the Columbia scale or Patient Health Questionnaire-9 (PHQ-9)) and clinical impressions captured in the Clairity app. Relevant data can be securely imported from other tech platforms or records. Clairity is fully HIPAA-compliant to ensure privacy and security of data.

Smart session support

Clairity is designed to be a seamless, noninvasive addition to a therapy session, but can provide clinicians a sense of comfort knowing there is an extra “ear” in the room. Following the session, Clairity returns individualized session summaries for the clinician, including the AI results as well as Wordclouds, analytics and summaries of the assessments and clinical impression ratings. The clinician can easily zoom out to view the client’s treatment progress over time to track trends or refresh their memory from previous sessions. At the caseload level, a clinician can track their “radar” to quickly see who is at risk.

Mental health professionals deserve cutting-edge technology

Clarigent Health believes that mental health professionals deserve support and cutting-edge technology. We have seen so many new solutions emerge that have improved our lives and our health. We know it is easier to manage our health when we have a wealth of data and clear analytics. Why should our mental health be any different? 

For additional information about Clarigent Health and Clairity, go to clarigenthealth.com and follow us on LinkedIn, Twitter, Facebook and Instagram

Disclaimer: This post is for informational purposes only and it is intended to assist other clinicians in the practice of psychology. It is not an advertisement nor intended to be used for legal, ethical, clinical, or medical advice.

Purpose of the listserv. As a reminder, the purpose of OPA listservs is to provide a place for Ohio psychologists and OPA members to discuss psychology-related topics and issues.  Topics for posts may include referrals, informal advertising, sharing resources and advocacy/social justice.  With the upcoming federal election, this is the time to remind members that the listserv is not a place for political discussion or comments unrelated to the field of psychology.  

Reminder to follow the ethical code.  All licensed psychologists know and adhere to the American Psychological Association’s (APA) Ethical Principles of Psychologists and Code of Conduct.  The updated guidelines remind OPA members of this and directly consider all listserv activity to be professional activity; this means the APA Code of Ethics must be applied to all listserv activity.  As a reminder, the general principles include doing no harm, building trust and taking responsibility for behaviors, promoting honesty, being fair and just, and having respect for people’s rights and dignity.  This latter principle includes protecting the privacy and confidentiality of clients and also respecting all cultural, indivdiual, and role differences for all individuals and groups. 

Differentiation between informal and formal advertising.  The updated guidelines clearly illustrate the difference between informal and formal advertising, which is as follows:  

• Informal advertising is allowed on the listserv.  These types of posts do not include fliers, websites, links, attachments, or detailed information.  Any post regarding informal advertising must ask those interested to contact the author backchannel (i.e., “reply all” responses are not allowed).
• Formal advertisements are considered a product for commercial gain and are not allowed on the listserv.  These types of advertisements include direct solicitations to purchase products or services and notices regarding rental of office space; they also include fliers, websites, links, attachments, or detailed information.  For those interested in formal advertising, formal advertisements for job postings may be sent to the OPA Career Center; those related to office space, continuing education opportunities, or items for sale, go to the Classified Ads section; and all continuing education (CE) opportunities should be directed to OPA’s Office of Mandatory Continuing Education (MCE). 

Reminder to use professional language.  Unprofessional language and comments are not permitted on the listserv.  All posts are expected to use courteous and respectful language and to respect cultural, individual, and role differences.  Derogatory comments of any kind about any individual, group, or institution are not permitted.  Name calling, bullying, micro-aggressions, and demeaning comments directed at other list members will not be tolerated.  Furthermore, listservs are not to be used to communicate any type of support, opposition, or endorsement for any candidate or specific political party for any federal, local, or state office.  

Again, these are only a few of the revisions featured in this newest update of the listserv guidelines.  Please take a couple minutes now to review the entire document online.  It is very important that we all take pride in our online community and continue working hard to keep it a safe and respectful space for all. We all need to focus on being considerate and as supportive of each other as possible, especially with the current state of the world and country.  

As many of you are aware, OPA has a number of committees, subcommittees, and task forces to which many members volunteer their time and energy. These groups create space for Ohio psychologists to join together, discuss common interests, advocate for the field, gain valuable professional contacts, and build lifelong friendships. These are just of few of the many benefits as the list is never ending. OPA’s committees are what keep our field and organization moving forward and participation is well worth it. A complete list of committees, subcommittees, task forces, and affiliates can be found here.

With the new biennium, I would like to introduce an ongoing series called “Committee Spotlight” that introduces you to individual groups and purposes within OPA. It will spotlight different committees, subcommittees, or task forces throughout the biennium with the purpose of informing you, the members, of their presence and purpose. Some groups may be seeking new membership, leaderships roles, or volunteers for projects. Commitment levels often vary and depend on your availability. If you ever had the thought to become more involved in OPA or professional development in general, committee work is a good place to start. Keep your eyes open for future spotlights in this series. 

For now, I would like to introduce the Science Committee, which is chaired by Dr. Kim Burkhart. 

The Science Committee is focused on the intersection between science and clinical practice. Its members consist of psychologists that work in a variety of settings including academic medical centers, group practice, private practice, and in the school setting. Historically, the Science Committee has been involved in OPA’s annual Convention, the review of Institutional Review Board (IRB) submissions, and judging of State Science Day, an annual competition for Ohio’s high school students to complete independent research projects in a variety of fields. The Science Committee also has involvement in supporting grant submissions to OPA. 

The committee is currently pursuing to establish partnerships with the Education Committee, Disaster Relief Task Force, Opioid Crisis Task Force, and OSPA. Current initiatives of our committee include:  1) Supporting the use of evidence-based tools and methods for diagnosis and intervention, 2) Increasing dialogue and collaboration between school psychologists and practicing clinical psychologists, 3) Identifying empirically-supported interventions in response to disasters, crises, and other catastrophic events, and 4) Developing workshops, webinars, and modules that advance the practice of incorporating science into clinical practice. 

The Science Committee is currently welcoming committee members. It is especially a great atmosphere for member of Early Career Psychologists (ECP), Ohio School Psychologists Association (OSPA), and Ohio Psychological Association of Graduate Students (OPAGS). For questions and/or to pursue involvement in the Science Committee, please email Kim Burkhart. We hope to see many new faces soon!

Written by: Mark Babula, PsyD | Regional Representative, Toledo Area Academy of Professional Psychologists | Member, Communications and Technology Committee

In 2017 I was given the honor of attending the Association of State and Provincial Psychology Board (ASPPB) Summit on the Psychology Interjurisdictional Compact (PSYPACT). Psychologists and legislators from all over our country gathered together to learn about and discuss how this compact could benefit so many.  When I began learning about PSYPACT, I did not know what a compact even was. I have since learned it is a way for states and other jurisdictions, such as Washington, D.C. and Puerto Rico, to work together through an agreement. The specific purpose of PSYPACT is to help states and other jurisdictions cooperate to provide psychological services to those in need. 

A main component of PSYPACT is to allow for telepsychology practice across state lines. As clients travel for business, school, vacation, or numerous other reasons, continuity of care can be difficult. We, as psychologists, then face the dilemma of how best to provide for their care. I have encountered some practitioners who, unintentionally, practiced illegally by continuing sessions by phone or video when they or a client were out of state. Others do their best to transition to another provider locally. This has been an issue for college students, spending several months in one area and then several months in another. The current pandemic has made the difficulties all the more apparent, with these disruptions happening so suddenly.

What has also become more apparent is the ability to conduct sessions remotely. Although the pandemic situation has increased the need for these services, remote therapy services existed before the pandemic and will persist into the future. Along with continuity of care, access is another focus of PSYPACT. There are individuals living in rural areas, lacking transportation, coping with mobility issues, and facing other obstacles to accessing mental health services. PSYPACT expands the pool of providers able to serve these individuals, and promotes use of telepsychology as a field. PSYPACT also reduces barriers, allowing psychologists with specialty practices, and clients with special needs, to connect more easily. This can help to overcome cultural differences, language barriers, and other obstacles that may arise when resources are limited. Research has repeatedly supported the efficacy of services delivered through video chat. By choice or necessity, many of us have transitioned to conducting all or portions of our practices this way and many plan to continue doing so.

PSYPACT also has a provision for temporary, in-person practice across state lines. Many states already allow for this, but PSYPACT consolidates and streamlines the process. This can, again, allow for increased access to specialty services and help to increase resources in areas in which mental health service is limited.

It is nice to think back to when I attended the ASPPB summit and first heard about PSYPACT.   Particularly in these isolating and divisive times, I remember how people gathered together to work on a project meant to be unifying and inclusive. Since that time, PSYPACT has become active nationally: 15 states have already passed PSYPACT into law, with 12 more states and Washington, D.C. having pending legislation to enact it.  Currently, legislation for PSYPACT has passed in the Ohio State Senate, and it is preparing to be heard and voted on in the House of Representatives. If passed, PSYPACT becomes law in Ohio, giving Ohio psychologists and other residents the benefits noted above. Psychologists would then need to apply for an E.Passport to provide telepsychological services or an Interjurisdictional Practice Certificate (IPC) for temporary in-person practice.  In the end, this agreement would allow Ohio psychologists to legally and ethically provide all telespychological services to any of the cooperating jurisdictions who have also joined PSYPACT. 

For anyone wanting more information, ASPPB has organized a wealth of information about PSYPACT including its history, procedures, and benefits at https://psypact.org/.  Members of the OPA Advocacy committee recently drafted a letter to help psychologists advocate for PSYCPACT with their local representatives; this letter has been emailed to all OPA members and it only a takes a couple minutes to send it along its way.  With everyone’s help, we can get PSYPACT passed and put into motion in the very near future, when it is needed more than ever.

Written by: Kelly Martincin, Ph.D., Co-chair of OPA Communications and Technology Committee, Chair of OPA Public Sector Interests Committee

As with all CTC blog postings, this column is not intended for medical, legal, or ethical advice; it is purely for information sharing and is the experience of one psychologist attempting to be useful to her peers during a very difficult time.   Several weeks ago, Mr. Michael Ranney, CEO of OPA, shared the “Stress in the time of COVID” article from APA, which captured something fairly obvious to most people – Americans are STRESSED.  This article stated that 67% of Americans are reporting they are experiencing stress related to the government response to COVID 19, and people of color are experiencing higher rates of stress than white adults.  Similarly, you may have seen the previous CTC blog postings by my colleagues Drs. Bryant and Quinn about the stress that Ohio psychologists are facing related to returning to the office and the difficulty in making decisions as a result of the pandemic, or some of my writing about my reactions to the murder of George Floyd and others and the resulting protests.  These are difficult times for everyone.    

Even in normal times, stress is pervasive in American society; however, a pandemic with recent reminders of the dramatic racial disparities in society clearly escalates our stress levels.  Furthermore, the pandemic complicates our ability to cope with stress. Risks to one’s health and the health of family and other loved ones are constantly on one’s mind; for many people, work has been dramatically impacted with some people working longer hours and others working fewer hours resulting in loss of income.  Additionally, common outlets for stress such as going to the gym or getting dinner with friends have either been taken away completely or become incredibly complicated.  All of this continues to ratchet up our stress, which we have to address or else we – and our patients - will suffer. 

One common trait that I notice amongst psychologists (and I definitely include myself in this group) is that we have a tendency to neglect our own self-care.  I spend my day touting the importance of maintaining one’s emotional wellness to patients and sometimes even co-workers, but then I will go home mindlessly push through my own “to do” list.  I might even skip meals or extra sleep to make sure I attend to something I believe “needs” to be done.  It takes a lot for me to pull myself out of the “do more” mindset and schedule time for meditation, a yoga session/other workout, or even a favorite activity such as reading a book.  When I am able to get myself into the “groove” of doing these things, I know I am better for myself and I often feel more effective at work, thus I hope I am also better able to serve my patients.  So how do we get out of the stress cycle right now, to help both ourselves and others?

Whenever I think self-care, I think of OPA’s wellness guru, Dr. Howard Fradkin, the chair of OPA’s Prevention and Wellness program.  I reached out to Dr. Fradkin earlier and mentioned my dilemma to him.  He framed the question in an incredibly eloquent fashion:  

“You know how health-conscious leaders are now having to promote wearing a mask as a cool way to protect yourself while giving the gift of health to others?  What if we thought about self-care practices in the same way—both as a cool way to protect ourselves while giving the gift of health to others?”  

I love the paradigm shift that Dr. Fradkin proposes.  As psychologists, we have long known that mental health IS physical health.  Why am I willing to wear a mask to protect myself and others, but yet it’s so hard to block an extra 15 minutes of my day for meditation or another self-care activity?  And more importantly, I’m more than willing to promote public health measures and even work to make them trendy – why can’t I do the same for self-care?  I was thinking about this earlier in the week when a coworker complimented me on my mask (I have several at this point and I’ve been trying to match them to my outfits).  I actively work at trying to make public health fashionable, how can I do the same for self-care?   They are, after all, the same.  

To answer my own question, here is what I came up:  First and foremost, start at home.  What areas of your self-care have you been neglecting?  Here are some ideas:  

• If you want some support in this area, OPA has you covered.  The Prevention and Wellness Program routinely host Self-Care Assemblies, co-facilitated by Dr. Fradkin and Dr. Tishler.  This is “a safe and open forum to talk about what challenges you are currently facing and to share your cool wisdom you have been learning during the pandemic.”  Visit the PWP page to learn more and pay attention to the OPA announcements for when the next one will be hosted!  These events fill up fast! 
  
• I routinely use meditation as part of my practice at work, but bringing this home has been a struggle.  I found this review from the NY times helpful in picking an app to bring some structure to my personal practice.  There are also lots of great free options (some from major medical centers) such as VA’s Mindfulness Coach, Cleveland Clinic’s Stress Free Now, and more.  
  
• Perhaps you’ve been needing a physical outlet for stress.  The CDC has multiple pages of information on maintaining our physical wellness during COVID 19, including overcoming barriers to physical activity during this difficult time.  
  
• Don’t forget to keep your social relationships strong right now!  It’s been a while since I’ve actually seen most friends and family in person, but I’ve had several people recommend scheduling a phone call or video visit once a week to a connect with a loved one.  Find what works for you, but consider scheduling it the way you would have scheduled a dinner or coffee date with that person pre-pandemic.
  
• Also strongly consider taking time to take an internal appraisal of your own mental health at least once a week.  We’re so good at spotting signs of distress and burn out in others, but are we missing the signs in ourselves?  It only takes a minute to ask ourselves a few basic questions:  How is my mood today?  How am I sleeping?  Has my ability to concentrate changed?  Have patterns such as my eating or alcohol use changed?  Am I experiencing any physical symptoms such as headaches or stomach aches?  Anything that might worry us in our patients should also be attended to in our own lives.  
  

Next task, how do we get others on-board for what could hopefully become a wellness wave?  How do we advertise and make this “cool” to do?  This seems like a bigger challenge, but these are some ideas:

• I’m going to try to be better about sharing with friends the new things I’m trying.  For example, if I find an online yoga class, perhaps I’ll call a friend to join me instead of logging in alone. 
  
• It’s also a good idea to ask others to share what they’re doing to care for themselves, for instance I reached out to Dr. Fradkin asking for his expertise in this area.  Inviting others to help us brainstorm for our own self-care practice can help build the hype!
  
• I’m also going to be re-framing my language that I use both with myself and with others that self-care is also care for others.  I’m better for my family, my friends, and my patients when I’m well rested and less stressed, so using this language is important.
  
• Social media can also be a very powerful tool.  I already follow OPA on my social media accounts and share upcoming events as well as articles from the CDC, WHO, and major news outlets about public health.  We can all use this tool for sharing more about self-care and wellness tools.  

Making changes for ourselves is certainly hard, and encouraging others to make changes is even harder.  Shifting the paradigm of self-care won’t be easy, especially in the midst of a pandemic, however it’s not impossible.  I invite everyone to join me in making it a priority!   

Have a topic that you’d like to see covered in a future CTC blog post?  Please email me and let CTC do the research for you!

As indicated in last week’s CTC blog, OPA hosted an online event titled Unlocking the Lockdown: Keying into Reopening Your Psychological Practice Virtual Town Hall on June 5, 2020.  Panelists were invited to speak in the areas of public health and medicine, professional practice issues, insurance and billing, and legal and ethical considerations.  The complete event can be viewed online.  The first half of the town hall was reviewed in last week’s blog, while this post will cover the areas of insurance and billing as well as legal and ethical considerations. 

Dr. Jim Broyles is the Director of Professional Affairs for OPA.  He has served in numerous positions in OPA over the years and he currently co-chairs Leadership Development Academy.  Dr. Broyles also has a private practice in Grove City, Ohio and he specializes in working with children, adolescents, families, and LGBT issues.  In his speech for the town hall, Dr. Broyles identified a number of misconceptions working their way through the field and provided the following key points: 

Insurance companies will not be ending telehealth coverage anytime soon.  Almost all have already extended their original cutoff dates and many more have coincided their expirations with the end of the current state of emergency in the country. 

Most insurance companies already covered telehealth services prior to COVID-19, however, there were many stipulations that resulted in significant barriers to widespread use.  For example, telehealth had to occur on specific web-based platforms, attestations had to go directly though the company, visual and auditory were mandatory, etc.  These requirements became more relaxed when COVID spread to the United States resulting in businesses having to close, mandatory quarantines, and stay at home orders being issued.  It is Dr. Broyles’ opinion that the previous standards will be reinstated once the current state of emergency has ended. He stated insurance companies are doing a good job monitoring the current situation.  They are responding to clinicians’ needs and will likely continue revising their services as necessary. 

Bob Stinson, Psy.D., J.D., LICDC-CS, ABPP, is a board-certified forensic psychologist, an attorney at law, and a licensed independent chemical dependency counselor – clinical supervisor.  He has had many roles in the forensics field and taught numerous college-level courses.  He also lectures across the country in the areas of mental health law and ethics.  Dr. Stinson holds membership in several legal and psychological professional associations as well.  At OPA, he is a Past-President and past-chair of the Ethics Committee.  In his law practice, he represents professionals as it relates to licensing board issues and related matters.  Dr. Stinson organized his presentation for the town hall around three areas described below.

Basic Considerations for Employers

Employers should discourage anyone from coming into work who have flu-like symptoms. 

Employers are able to require symptom checks/screenings if they use accurate and reliable measures.  This allows uniform procedures while avoiding discrimination.  Employers can also have a policy in place that requires employees and clients to do self-assessments using the Center for Disease Control and Prevention (CDC) guidelines.  These procedures should all be described and indicated in a written agreement. 

Employers are allowed to inquire if employees have tested positive for COVID, but employees are not required to voluntarily come forward to inform employers of a positive diagnosis; however, employers can put policies into place requiring such a report.  If this policy is developed, be sure it includes a specific process that limits discrimination.  It could be helpful to have employees make reports to an individual who does not have authority in the office. 

Paid sick leave is available for employers testing positive with COVID or those required to care for individuals who are diagnosed. 

Employers are currently not required to report positive diagnoses to the health department.

Considerations for Returning to In-Person Services

Clinicians are not professionally obligated to offer face to face services. 

Ask yourself if it is necessary to see people in-person.  Take into account the client’s internet access, knowledge of telehealth, and treatment.  Always review the risks.

Implement policies to protect both employees and clients that limit exposure.  For example, open windows for ventilation, ask clients to wait in cars prior to their appointment times, wear masks and gloves, use hand sanitizer and tissues, agree to do self-assessments, etc.  Be sure to describe what happens if clients choose not to come into the office. 

Remember, services can always revert back to telehealth or referrals can be made if they insist on in-person services you are unable to provide. 

Have Special Informed Consent for the Transition to In-Person Services

Having a COVID-specific informed consent for returning to in-person services does not replace regular informed consent forms.  This paperwork identifies precautions and responsibilities you place on clients.  Include what you will do if you have symptoms as well as a statement on the limits of confidentiality (for example, you may be required to report COVID cases if current policies change in the future). 

All clinicians take on liability by practicing in the field of psychology.  Remember, in order for there to be liability, there must be three elements: 1) A professional duty to the client, 2) a breach in that duty, and 3) evidence that the injury is caused by that breach.  Dr. Stinson stated this may be difficult to do in regards to the spread of COVID-19.

At the end of the Town Hall, I was relieved to finally have so much information coming directly from the professionals.  Like so many other psychologists, I am not an expert in medicine, ethics, insurance, or the law, but these are the areas so many of my questions and worries come from.  Before last Friday, I had heard contradicting information on various measures and worried I was making errors in my own transition back to the office.  I similarly worried about insurance coverage and ethical/legal matters.  After attending the Town Hall and listening to the real experts in these areas, I now feel more knowledgeable and confident in the procedures and policies I plan to put in place when it comes to COVID.   Many thanks to the wonderful presenters and OPA staff who clearly worked so hard to present such helpful information for Ohio’s psychologists as we all begin exploring our “new normal” together!

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Disclaimer: This post is for informational purposes only and it is intended to assist other clinicians in the practice of psychology.  It is not intended for legal, ethical, clinical, or medical advice.

OPA hosted an online event titled Unlocking the Lockdown: Keying into Reopening Your Psychological Practice Virtual Town Hall on June 5, 2020.  Panelists were invited to speak in the areas of public health and medicine, professional practice issues, insurance and billing, and legal and ethical considerations.  More than 50 OPA members were able to attend and gain answers to questions we are all asking.  The complete event can be viewed here.  This blog will focus on the first half of the town hall covering the areas of public health and medicine and professional practice issues.  Stay tuned for next week’s post to learn more about the second half.  

Public Health and Medicine
Heidi Gullett, MD, MPH is an associate professor in the Center for Community Health Integration at Case Western Reserve University (CWRU), a liaison at the Cuyahoga County Board of Health, and medical director of the Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga), a large cross-sector community health improvement consortium.  

Dr. Gullett began Friday’s night’s discussion with an update of Ohio’s statistics related to COVID-19.  There are currently more than 37,000 cases and over 2,300 deaths in Ohio- numbers that are expected to increase with the reopening of public places.  She stated it is important to know and understand the context of COVID in your local areas as well as the overall impact for the state.  

With the message of “this is a marathon, not sprint,” Dr. Gullett reiterated that COVID is not expected to disappear anytime soon.  Taking the proper precautions now will build healthier habits for a possible next round expected to come in the fall or winter of 2020.  Here are some of the many helpful suggestions Dr. Gullett discussed:

Social distancing is absolutely critical.  Although the standard recommendation is six feet, no exact number is known; in other words, COVID can be contracted in a distance either more or less than six feet.  

Send the message that the purpose of social distancing is to protect. Talk “very intentionally” about what social distancing means and the exact expectations of both clients and clinicians (e.g., wait in vehicles until appointment times, do not sit next to individuals outside of your family, no physical contact, etc.).  She stated no one can be too concrete with their explanations because social distancing is not the norm for so many Americans and it is easy to forget.  

It is possible to require health assessments for both clinicians and clients to come into the office.  The expectations must be extremely specific and concrete.  For example, instead of saying “Don’t come in if you experience flu-like symptoms,” list out the symptoms: “Please do not come in if you have a fever of more than 100 degrees Fahrenheit; have a cough and/or shortness of breath; experience any two of the following: fever, chills, repeated shaking with chills, muscle pain, headache, sore throat.” This means both going in to work as well as going out in public for any reason other than to pursue medical treatment (e.g. grocery shopping). 

Facial coverings protect the wearer from receiving and projecting the virus.  Dr. Gullet indicated she would not feel comfortable sitting in a room with someone for 50 minutes with no masks in place, even with six feet between all individuals.  Air circulation, movement, and talking styles must all be taken into account.  Face shields are used by some, but there is still potential to contract COVID.  

It is critically important to wash hands as well as commonly used items.  Use cleaners that are meant to kill the coronavirus.  Dr. Gullett indicated a list of alternatives to use when cleaning supplies run out can be found on the Ohio Department of Health’s website.  

Professional Practice Issues
Dr. Matthew Capezzuto, is a clinical psychologist, a clinical social worker, and the founder and Executive Director of Allied Behavioral Health Services, Incorporated- a multi-site behavioral health agency that serves several Northeast Ohio communities.  As an administrator, he has developed vast working knowledge of the intricacies of the behavioral health care industry and the continuously evolving regulatory standards that govern the practices of behavioral health care providers. He presented with Dr. Virginia Fowkes Clark, who is a clinical psychologist who provides treatment to clients of all ages with a specialty in the assessment and treatment of children and adolescents. She has owned and directed a group private practice, Western Reserve Psychological Associates, Inc., and she is presently the Vice President of Professional Practice for OPA and on the Insurance Committee.

It is Dr. Capezzuto’s recommendation that telepsychology services continue where possible.  To provide a framework for conceptualizing a reopening, he focused on the areas of solo practice, small group, large group, and agency.  Below are key points in his discussion. 

In each of these areas, it is very important to be aware of state licensing rules for telehealth as well as reopening, emergency revisions, state orders, and limitations for implementing practices.  

Develop a reopening policy to put in place.  It can start at one to two pages, but expect to update it with each change in rules and guidelines in the future.  It can be helpful to receive input from clinicians (which will help with their compliance) and hold regular meetings to review and revise as necessary.  

The biggest lesson is to protect yourself from COVID.  Clinicians are under no obligation to return to in-person services.  If this is the chosen path, be aware of legal liabilities, civil suits (by clients, family, visitors, staff), and potential violations of federal, state, or local rules.  

Always evaluate your ability to maintain supplies to ensure care of yourself and others.  

Dr. Clark added that documentation is key during the process of reopening.  Clinicians should be able to justify their decisions of whether to see clients through telepsychology or in-person.  Many professional organizations have already provided sample forms, such as the following: 

Sample informed consent form for resuming in-person services by APA

Guidelines for Psychological Routine Care Reopening by the Arkansas Department of Health

A number of COVID-related resources can be found on OPA’s website

Go directly to your liability insurance provider for their recommended guidelines for reopening, forms, and legal guidance

Go online to view the complete town hall.  It was very beneficial for those able to join.  Like so many other online events that have occurred since COVID came to the United States, it was nice to see those in our field come together to learn, ask questions, and support one another.  I was very glad to see that many of the attendants were asking the same questions bouncing around in my own head.  This is yet another example of how OPA has helped create a sense of community to let me know that I am not alone.  Please return next week to learn more about the second half of this town hall focusing on insurance and billing and legal and ethical considerations. 

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Disclaimer: This post is for informational purposes only and it is intended to assist other clinicians in the practice of psychology.  It is not intended for legal, ethical, clinical, or medical advice.  

As with all CTC blog postings, this column is not intended for medical, legal, or ethical advice; it is purely for information sharing and is the experience of one psychologist attempting to be useful to her peers during a very difficult time.  While I typically do try not to disclose too much personal information in these blog postings, I feel it’s important to share that I identify as a White, cis-gender woman.  My lens of privilege cannot be ignored as I share my thoughts on race and social justice.  Similar to many others, I often feel powerless to change the horrible dynamics that sometimes feel overwhelming in society, but then I am forced to remind myself that my privilege also gives me power to help.  That is what I am hoping to achieve, at least in a small way, with this blog post today.   

Sadly, I sit at my computer again and my heart is heavy. The tragic murder of George Floyd has provided yet another example of a Black man who did not have to die, and this is becoming all too familiar.  Perhaps you saw my CTC blog a few weeks ago on social divides where I touched on many things that are examples of how we are divided as a nation.  In that article, I mentioned my sadness over the Ahmaud Arbery and Breonna Taylor killings as well as the deeply personal reactions of several of my patients, how they, as people of color, felt unsafe doing everyday things such as jogging or even sleeping in their own beds. As I prepare for work this week, I know I will again be having these conversations because we need to be having these conversations.  People of color need to be seen and heard, and not just by their psychologists.  

The recent murders sadly capture what has already been apparent for many months.  Racial disparities are present in all levels of society.  As highlighted in my previous blog posting, racial minorities are dying of COVID 19 at higher rates than Whites (see CDC website for more info) and unemployment rates are higher for minorities than for Whites (see Bureau of Labor Statistics if you’d like to examine the specific data; employment rates of Blacks was nearly double that of Whites prior to the pandemic).  Furthermore, a 2019 study from the University of Michigan, Rutgers University, and Washington University found that death from excessive use of force by police is the 6th leading cause of death for young Black men and Black men are 2.5x more likely to be killed by police than Whites.  Any one of these facts is highly disturbing, but taken together it’s absolutely breathtaking what a profound structural issue we have at every level of society.  We’re failing dramatically, and we have to do better.  

As one lone person, I sometimes feel rather helpless as to what I can possibly do to help this situation.  As a White person, it’s hard not to get stuck in feelings of guilt about how I’ve benefitted from my privilege and wonder if I’ve ever participated in systems of oppression (it’s nearly impossible to think that I haven’t in some way participated in oppression).  I’m certainly not perfect and I have a long way to go in learning about my privilege and how I can help dismantle racist ideologies in society, but here are some thoughts on ways each one of us can DO SOMETHING: 

• Acknowledge that we are not in a post-racial society.  I try to avoid using phrases such as “I don’t see color” because color is present, it’s part of our culture, and we can celebrate our differences.  Our use of language should reflect this. 
  
• I’ve been trying to take more time to learn about my privilege as a White person.  The author Peggy McIntosh was particularly helpful in providing concrete examples of how privilege is active in my life.   If you are interested, now might be a good time to also examine aspects of privilege in your life and how this might be shaping your worldview. If you feel you have a good handle on the literature available of White privilege, step into the literature on White fragility.  This literature has been helpful for me in understanding why more people don’t step forward into the difficult conversations and act on the problems with race in society today as well as understanding some of my own emotions and struggles. 
  
• Be on the lookout for microaggressions, both from yourself and from others.  A microaggression is a brief comment or action (intention or unintentional) that transmits a derogatory message about a stigmatized group.  Often we react to microaggressions by thinking “Was that racist?” or “That was a little bit racist.”  If we’re wondering if a comment or action was racist, it was probably racist and we should say or do something.  There is no such thing as “a little bit racist,” it’s just plain racist, so speak up.  Similarly, if someone gives you feedback that a comment wasn’t entirely appropriate and you weren’t intending to be offensive or were joking, try not to be defensive and take the feedback to heart. Accept that we are all guilty of microaggressions and they are often unintentional.  We should all do our best to remove offensive language including jokes from our vernacular.  
  
• Don’t get distracted from the bigger issues.  Like many others, I’ve been horrified by the violence that has resulted from some of the protests this past week, both in my own community and around the country.  I’ve noticed in various forums on social media and on the news that some people have used this as way to distract themselves from the bigger issue of the huge racial disparities in our nation.  While this is difficult to view and should not be encouraged, the violence of these protests is a symptom and not the disease.  If we want to stop this violence, we must work towards racial equality, plain and simple.  Don’t lose focus on what is most important – equality for all. 
  
• White people, we can’t focus on our feelings right now.  One area I commonly get caught in is feelings of guilt or shame and wanting to apologize for being White.  I have to realize that this is not about me or my feelings.  We have to put the thoughts and feelings of people of color center stage at this time and make sure they are seen and heard.  It’s far more important that I focus on listening and really understanding the experiences of people of color from their standpoint and I can focus on my own reaction later.  
  
• What about supporting Law Enforcement?  Isn’t that ideologically at odds with Black Lives Matter and other groups working to advance racial equality? No!  Definitely not!  We should all support law enforcement and promote healthy dialogue right now too! I’ve self-disclosed a great deal in this blog and I will share one more very important thing.  My partner is a law enforcement officer.  This past week our home has been full of important, heavy conversations about our mutual horror at the death of George Floyd and others.  I promise that you can support Black Lives Matter, believe that there must be huge changes in our nation including elimination of police brutality, while also support law enforcement officers all at the same time – I do.  Law enforcement must be included in these conversations if there is ever to be any meaningful change.  We must support those officers who serve for the right reasons and want to promote healthy change in the culture of law enforcement while also engaging those who might be ambivalent about change to educate them on the opportunities that can come with advancement of peace and equality.  
  

These are only a few small things that I, as one lone person, can do immediately to try to make a difference.  I encourage you to consider what you, from your unique position and perspective can do.  As psychologists, we each entered this field to make a difference.  The time is now.  Action is needed.  Most of us likely cannot make large sweeping changes on our own, but if we could all find a handful of small ways to make changes, imagine what we could all do together.  

Using Survey Results to Inform Decisions- Dr. Keelan Quinn
Since March of 2020, the United States has been completely turned upside down with the spread of COVID-19 in the United States.  A state of emergency was issued and quarantines were put in place.  Social gatherings were canceled and many common household items were sold out and became unavailable.  Unsurprisingly, our field of psychology was also deeply impacted as so many of us were expected to work remotely from home using telepsychology.  As quarantines began lifting this month, many of us began questioning what we should do in our practices.  Should we return to in-person sessions or continue telepsychology?  If we do return, how do we remain safe?  

Dr. Bailey Bryant, a psychologist in the Cincinnati area, came up with the idea of using an online survey to help her make some of these difficult decisions.  She distributed this survey to an online community of clinicians, of which 60 were able to respond.  As of May 15, 2020, the majority of clinicians who responded continued seeing clients through telepsychology only.  For those who decided not to return to in-person sessions, they indicated they would re-evaluate that choice in a few weeks.  Almost all who were returning to the office were making changes to their practices in some way whether in day-to-day practice or in the physical space.  There was no consensus regarding the clinicians’ confidence in their decision of whether or not to return to the office.  “It is super confusing at best” and “This is SUPER stressful” were two quotes included in survey results to describe this decision-making process.  You can see all results as well as many powerful quotes provided by clinicians here.  

The use of surveys in the field of psychology is nothing new.  For decades, they have provided valuable information for research and evaluations everywhere from universities and hospitals to agencies and private practices.  Another way to use surveys in psychology is for clinicians to gather information for decision-making purposes.  Below illustrates a detailed account of how Dr. Bailey did just that.

When Are Therapists Returning to the Office?  The Results Are In - Dr. Bailey Bryant
I’m a psychologist, a therapist, a practice owner, and a highly confused individual. The past two months were quite the emotional roller coaster as I transitioned my group practice to telehealth overnight. In early March I struggled to make the decision to shift to telehealth due to analysis paralysis and so I did what all healthy adults do- I turned to Facebook (tongue in cheek). I put up a Facebook poll in the Cincinnati Area Therapist Network group and quickly saw the emerging trend of therapists making the call to go to telehealth only. The poll and the comments tipped the scales and gave me the data, support, and confidence to make the shift. Once I decided to transition to telehealth only, and after I brushed up on my telehealth ethics and sent out my consent forms, I breathed a sigh of relief. The next few days were a bit challenging but then I settled in and I have been in front of a computer screen ever since. 

Flash forward to today and I find myself again stuck in analysis paralysis. As restrictions are lifting, people are emerging from the shadows and therapists are starting to come out from behind their computer screens. Now I feel more confused than ever. We are allowed to leave our homes and patron businesses, but should we? We can meet with clients in person, but is that safe? How do I proceed in opening my doors to clients? Is it any safer now than it was in March? How do I clean the office? Do I take clients’ temperatures? There is a never-ending thread to pull and my anxious brain is having a heyday finding all the loose strings.

I took the liberty to create another survey asking therapists in the Cincinnati area about their plans for returning to in-person sessions and the precautions they intend to implement. This survey was somewhat more sophisticated than my initial poll and I was shocked when 60 mental health therapists responded. When I viewed the results of my first Facebook poll in early March I felt that I had data to support a decision; I did not have the same experience with this most recent survey as results were divided and there was no consensus.  If you review my results here, you will see that the philosophies on our responsibilities as practitioners to prioritize safety also varied widely. 

Reactions- Dr. Keelan Quinn
After reviewing the results of Dr. Bryant’s survey, I felt a sense of relief that I am not alone when I ask the question “What do we do?”  Like many others (I hope), I am interrogating every professional contact I see with “What are you are doing to stay safe?,” “What do your clients think?,”  “Can we get in trouble for returning to the office?,” or “Are people really suing over a public health crisis?”  These are scary times, but knowing what others are doing provides reassurance and helps calm my anxiety.  I feel better learning from others and hearing examples of what they are doing.  Seeing there were are no certainties or perfect answers among the survey results was initially disappointing, but then oddly validating.    

Reading the quotes within the survey results was especially powerful.  Some discuss interesting ways to meet client needs, while others focus on how some are taking precautions during this COVID-era.  Many of the quotes repeated the same worries that cycle through my head using my exact words- Will I lose clients?, Will I have to stop working?, What if I unknowingly contract COVID and pass it along to others?, or Am I being careless by working in the office with those who cannot do telehealth?  For someone who always has a plan A, B, and sometimes C, the uncertainty of the world today has been difficult to acknowledge and adjust to.  This experience with COVID has been a great life lesson that continues to teach me that I cannot control everything.  In the past couple months, I have become more patient, accepting, and, above all else, flexible.  Before, I would not have been able to handle the unknown, but with this experience, it is getting a bit easier each and every day.  This survey provided me a sense of validation and connection.  Knowing I am not alone and that there are no right or wrong answers now was especially comforting.  

What I do know as a certainty is that my clients still need services.  They are experiencing just as much stress and confusion as we clinicians do, and I refuse to abandon those who have come to depend on their appointments.  I am more than happy to focus on what I can control and that is how I provide clinical services.  The only thing we can do is think through the options, make an informed decision based on our beliefs and clinical judgment, document, and proceed.  

Dr. Bryant has created another survey focusing on how clinicians are making the decision of whether or not to return to in-person services.  I imagine the results to that survey will be just as informative and helpful in calming my nerves as the last and I look forward to seeing what comes up.  Go here to TAKE THE SURVEY.

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Disclaimer: This post is for informational purposes only and it is intended to assist other clinicians in the practice of psychology.  It is not intended for legal, ethical, or medical advice.  

Dr. Bailey Bryant is a Licensed Clinical Psychologist in the Cincinnati area.  She the owner of Hello Mental Health and Good Therapy LLC as well as the founder of Health Match 360.

As Ohio's Stay at Home order gradually begins lifting, many psychologists may slowly begin returning to the physical office. Although the original choice to close and that of whether to return may not be yours, depending on the setting where you practice, the choice of which clients/patients to see in-person versus through telepsychology may be.  Like so many other scenarios in this field, there are no concrete answers as to how to make this decision. To help with this process, the American Psychological Association (APA) has provided a number of guidelines for us to consider as we brave this next phase of COVID-19.  

Considerations for In-Person Sessions
APA published an excellent article written by Galietti, Wright, Higuchi, and Bukfa (2020) describing the process of returning to the office.  It can be found here and I highly recommend everyone read this informational piece.  Among other considerations for the process of returning to the physical office included in the article, the following are guidelines specific to determining whether in-person services are necessary:  

• Review state and local orders: verify whether or not in-person sessions are advisable before moving forward with in-person sessions.  
• Technological access and competence: consider whether the client/patient has continued and secure access to a telepsychology platform and is able to understand and use it competently.  Treatment may be impacted if issues arise in any of these areas.
• Progress and mental health risks: consider the diagnosis, whether the service is ongoing, and if the client/patient is making progress through telepsychology.  Those who may benefit from resuming in-person therapy may include those who appear to be worsening, are in acute crisis, pose of safety risk, or who require a more intense level of care that is not met via telepsychology.  
• Next phase of treatment: consider whether it is feasible to continue working with the client/patient remotely of if the next steps of treatment may require face-to-face contact.
• Review the physical risks: psychologists need to be aware of any and all physical health risks, which include the possible transmission of COVID-19 during in-person sessions.  Assess the client/patient’s health and consider whether the individual’s behaviors (e.g., willingness to follow social distancing rules and other health-conscious recommendations), health, occupation, and exposure to others place him/her at a higher risk for contracting the virus and spreading it to others through in-person sessions.  
• Clinician health: do not put your own health, or that of your family, staff, or other patients at risk.  You are not ethically or professionally obligated to offer in-person services to your clients/patient.
• Documentation: just like every other aspect of therapy, it is very important to document each step of the process you take when making this decision.  This includes noting the client/patient’s clinical progress, discussions about the benefits and risks of telepsychology, plans for next steps, and rationale for why you believe providing services via in-person or telepsychology is clinically appropriate.  APA is currently working on an informed consent form for in-person services specifically for this period of COVID-19.  A sample can be found here.  

Telepsychology Guidelines
The majority of psychologists have undoubtedly been using telepsychology as a primary delivery of services for the last couple months. For many, the transition to telepsychology was sudden and mandatory as businesses and offices were immediately closed to reduce the spread of COVID-19.  Although using telepsychology may now be second nature for many of us, it is always helpful to review the recommended guidelines of use.  A copy of the guidelines provided by Ohio Psychological Association (OPA) is found here while APA’s guidelines can be found here. 

Both associations highly recommend an assessment of the appropriateness of using telepsychology for each individual client/patient.  This includes examining the potential benefits (e.g., accessibility, convenience, etc.) of delivering telepsychology services relative to the risks (e.g., additional screen time, not in-person, safety, etc.).  Both should be communicated to the client to help him/her understand potential options.   

APA provides additional guidelines that may be helpful to determine which clients may be appropriate to begin or continue telepsychology services.  The following suggestions under the Standards of Care in the Delivery of Telepsychology Service guideline are just a few to consider in this decision-making process:

• Progress and mental health risks: consider the diagnosis and whether the presenting concerns can safely and efficiently be treated through telepsychology.  
• Client/patient preference for telepsychology: many individuals continue being hesitant to leave their homes and enter public places, and for good reason.  Take into account each client/patient’s physical health status and comfort level regarding coming into the office.  Client preference does not have to be the sole determinate of whether or not to continue telepsychology. 
• Client/Patient competence: consider the client/patient’s familiarity with and competency for using the specific technology platform involved in providing telepsychology services.  
• Remote environment: assess carefully whether the client/patient has the capacity and access to resources necessary to continue services via telepsychology.  This includes verifying the client/patient has a confidential space for services with limited distractions and interruptions.

Whether you decide to work in-person or to begin/continue through telepsychology, it is important to examine each client/patient individually.  Assess the appropriateness of in-person sessions versus telepsychology for each individual client/patient and the unique presenting concern.  Continue monitoring client/patient progress no matter the choice you make.  It does not have to be a permanent decision or an either/or scenario; some clinicians are electing to provide a combination of both options depending on the specific case.  Examples include seeing new clients/patients in-person until rapport is built before transitioning to telepsychology services; scheduling an in-person session every third or fourth session; and asking those at high-risk to be seen in-person.  No matter your decision, documentation is extremely important during this time.  Note each step of your decision-making process, discuss it with clients/patients, and add it to his/her file.  

Have questions or an idea for a future CTC blog?  Email Keelan Quinn.  

Disclaimer: This post is for informational purposes only and it is intended to assist other clinicians in the practice of psychology.  It is not intended for legal, ethical, or medical advice.  


References
Galietti, C., Wright V., Higuchi, S., and Bufka, L.  (2020, May 1).  COVID-19: When is it OK to resume in-person services?  American Psychological Association Services, Inc.  https://www.apaservices.org/practice/news/in-person-services-covid-19

Joint Task Force for the Development of Telepsychology Guidelines for Psychologists. (2013). Guidelines for the practice of telepsychology. American Psychologist, 68(9), 791–800. https://doi.org/10.1037/a0035001

Ohio Psychological Association Communications and Technology Committee.  (2008).  Telepsychology guidelines.  https://telehealth.org/wpress/wp-content/uploads/2013/11/TelepsychologyGuidelinesApproved041208.pdf

• If you are looking for general information on COVID 19, national policy, or keeping yourself and others safe, the Center for Disease Control is the place to start.  They have a wealth of information ranging from highly technical info geared at physicians to symptom checklists and suggestions for coping that is meant for all audiences.  
  
• For concerns more specific to Ohio, OPA’s Pandemic Resource page has a wealth of information!  Info on inter-state telepsychology laws, the latest insurance info from Dr. Jim Broyles, and so much more is available on this page.  It’s updated regularly so check back often.  
  
• American Psychological Association also has a great resource page on a very wide variety of topics.  They also have been offering free seminars on topics such as telepsychology, but these have been filling up fast so keep an eye out for these offerings! 
  
• The Suicide Prevention Resouce Center has info specifically on treating patients via telehealth during COVID 19.  This is a great reminder of best practices for some of our highest risk patients.   
  
• You’ve likely heard that domestic violence has been on the rise due to COVID 19.  If your patient or someone else in your life needs resources, check out the National Coalition Against Domestic Violence website. 

Some extras: 

• Headspace is offering free meditation during COVID 19. 
• For a cool distraction, the National Park Service website has “virtual getaways.”  This one honors Asian American and Pacific Islander Month, featuring Minidoka National Historic Site.  If you or your patients are missing travel, there is a lot of really neat content online for “virtual travel.”   
• If outdoor distractions aren’t your thing, The Metropolitan Museum of Art in New York has an excellent Art at Home section on their website full of awesome content.  

Have questions or an idea for a future CTC blog post?  Email Kelly Martincin.

Over the past month, many psychologists across the state have been learning a great deal about telehealth and videoconferencing.  For some of us, the curve has been very steep, for others the transition has been a little easier.  For me personally, I’ve used the teleconference platform Zoom for meetings previously, but it has now become a part of my daily life as so much more than meetings.  Get-togethers with friends, family events, and even my book club has moved to using this popular platform in the wake of the COVID 19 pandemic.   Most importantly for OPA members is that many psychologists across the state are adopting it for telepsychology.  Even though I work for a medical system that provides its own telepsychology platform, I did the research for what many practitioners probably want to know about Zoom.

Is Zoom HIPAA compliant?  Yes and no.  This depends on what plan you are using.  Zoom’s most popular plan is the free option, which has a few limitations including not being HIPAA compliant and limiting the user to 40 minute sessions.  The free option doesn’t have important features such as a Business Associate Agreement (BAA), which is an agreement of shared risk in the rare event that there would be a breach of privacy, thus it is not HIPAA compliant.  Zoom does offer a HIPAA compliant plan starting at $200 a month for 10 hosts.  This might be a bit pricey for small practices, but it could be a good fit for larger groups.  Keep in mind that right now there is a government waiver in place that we are not required to use HIPAA compliant platforms due to the pandemic, so you are able to use the free Zoom account as long as you take reasonable precautions to protect your patients’ privacy.  It is unclear how long that waiver will remain in place, but the State of Ohio will likely give us plenty of warning for when it will expire.

Speaking of patient privacy, what about security?  Similar to everyone else, I was very concerned when I heard about “Zoom bombing” (cases of interlopers disturbing meetings in a troublesome fashion).  Some of these stories were a little humorous (students interrupting a school board meeting and making noises of various bodily functions), but some were horrifying (a man’s dissertation defense being disrupted in a malicious fashion).   For telepsychology, any of the above would clearly be completely unacceptable.  Zoom has multiple security features that you will be able to use on the free version.  Sessions can be password protected and there is also a neat “waiting room feature” where the host can see who is waiting to enter the meeting and only allow the proper people to enter (an awesome feature for group therapy).  Once you are in the session, you can also click the “security” icon in the bottom middle right of the screen to “lock” the meeting and no one else will be able to enter after that.   Also of note, since these events began occurring, the Zoom team has been working diligently to enhance their encryption services (there any many news reports about this) and they are rolling out new features all the time.  

What special features might be helpful to know about when I’m doing therapy?  Beyond knowing how to use the security features mentioned above, one of the most helpful features to know about when working with patients would be the screen share feature (click “share screen” icon in the bottom middle of the screen).  This allows you to show what is on your computer screen in the event you would want to show your patient a handout or brief film clip.  With this feature, there is also a white board option that turns your screen into a white board for you to illustrate a point.   For group therapy, the chat box can be helpful for people to add text for questions or comments while someone else is talking (“chat” icon bottom middle of screen).  There are also features for creating a poll or recording the session if those would be helpful to you.  A final fun feature I’d like to mention is the ability to change your background (for example, the screen would show you sitting in a tranquil meadow or whatever image you choose instead of your office).  Friends who work with child and adolescent populations say this is a big hit with kids!  To do this, find the up carrot (^) next to the “start video” icon and click “choose virtual background.”  From there, find the plus sign (+) in the lower right of the box to “add image” and add a previously downloaded image from your computer.  Then you can click on that image and whatever image you have chosen (for Zoom meetings with friends, it’s my favorite Australian beach!) is now your background.  If you want to undo this, it’s the same process; once you are in the “choose virtual image” feature choose “none.”  

The decision about whether the use of Zoom is right for you and your practice is a highly personal one, but many people are finding it helpful to at least be familiar with the platform as more and more meetings are being held on Zoom.  It is possible that this will be a trend that will continue even post-pandemic due to the ease of use and popularity of Zoom. 

Have a topic that you’d like to see covered in a future Communication and Technology Committee's (CTC) blog post?  Please email Dr. Kelly Martincin, Co-Chair of the Communications and Technology Committee and let CTC do the research for you!