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Texas Psychologist 1WINTER 2003

Features

10 Career Trends for Texas Master’s Level Psychology Graduates

Emily Sutter, PhD; Howard Eisner, PhD; and Leslye Mize, PhD,

University of Houston - Clear Lake

18 The Empirically Validated Treatments Movement: A Practitioner Perspective

Ronald F. Levant, EdD, ABPP

22 Challenging Issues for Women at Midlife

Donna Davenport, PhD, Robert L. Nutt, PhD, Robbie N. Sharp, PhD, and Melb J.T.Vasquez, PhD

Departments

2 FROM THE PRESIDENT

Deanna Yates, PhD, TPA President

4 FROM TPA HEADQUARTERS:

Success Before Work

David White, CAE, TPA Executive Director

6 Texas Psychological Foundation Contributors

7 Council of Representatives

Joseph C. Kobos, PhD

9 LAS News from Houston Psychological Association

Julie Landis, PhD, HPA President

21 Texas Psychological Association Convention Sponsors

29 Sunrise Fund Contributors

29 PSY-PAC Contributors

30 PSY-PAC Update

30 New Members

33 Classified Advertising

33 Advertisers’ Index

Claire Jacobs, PhDEditor

David White, CAEExecutive Director

Robert McPherson, PhDDirector of Professional Affairs

Lynda KeenMembership Manager/Bookkeeper

Sherry ReismanDirector of Conventions & Non-Dues

TPA BOARD OF TRUSTEES

Deanna Yates, PhDPresident

C. Alan Hopewell, PhDPresident-Elect

Paul Burney, PhDPresident-Elect Designate

Walter Cubberly, PhDPast-President

Board MembersRon Cohorn, PhDPatrick Ellis, PhD

Richard Fulbright, PhDCharlotte Kimmel, PhDJoseph C. Kobos, PhD

Suzanne Mouton-Odum, PhDRoberta L. Nutt, PhD

Dean Paret, PhDElizabeth L. Richeson, PhD

Ollie Seay, PhDJarvis Wright, PhD

EX-OFFICIO BOARD MEMBERS

Richard M. McGraw, PhDFederal Advocacy Coordinator

Melba J. T. Vasquez, PhDCAPP Representative

Jerry R. Grammer, PhDTexas Psychology Foundation President

Mary MartinStudent Division Director

PUBLISHERRector Duncan & Associates

P.O. Box 14667Austin, Texas 78761

512-454-5262

Stephanie ShawManaging Editor

Jared HensleyAdvertising Sales

Julie ManganoArt Director

The Texas Psychological Association islocated at 1011 Meredith Drive, Suite4, Austin, Texas 78748. TexasPsychologist (ISSN 0749-3185) is theofficial publication of TPA and ispublished quarterly.

www.texaspsyc.org

WINTER 2003 VOLUME 54, ISSUE 4

Our legislative goal was to pass

prescriptive authority legislation

in 2003. We did not succeed thisyear; however, it is inevitable that Texas will

eventually get prescriptive authority just as

New Mexico has. I have personally beencommitted to prescriptive authority forpsychologists for many years, and I will

continue working with TPA and APA on

this issue until I see it become a reality inTexas. APA’s Division 55 is committed tothe advancement of psychopharmacology

and I will be working with a committee

whose goal is specifically to help states moveforward with this legislation. It may take afew more years, but we will succeed because

it is the right thing for our patients and it is

the natural evolution of the practice ofpsychology.

Another goal that I had for the year wasto establish two new TPA committees: oneto interact with third party payers and oneto focus on public policy. Both committees

were formed and have worked exceptionally

hard this first year. In the area of public

policy, TPA has begun to develop

relationships with many consumer groups

and hopes to continue to nurture these

relationships. Psychology needs to be

involved in setting mental health public

policy and forming alliances with consumer

groups is a step in that direction. With the

cuts in Medicaid that occurred at the end of

the regular legislative session, the third

party payers committee has been very active

in Austin, working to help get these services

restored. As I write this article, our

legislators are going into the third special

session, so it is still possible to get optional

services funded.

Another goal was to continue preparing

and positioning TPA to begin the Sunsetprocess. The Sunset Committee has metseveral times and has prepared changes in

our licensing act that we feel need to be

made. With the help of our lobbyists weare now working out our strategy, as wecould be in hearings before the Convention

begins. We have also continued to build

the funds to help with the Sunset effort. Iwould like to ask every psychologist whohas not yet sent in the $100.00 to please

make that contribution to the fund now.

Over the past several years, the leaders ofTPA have been working to make TPA anorganization that is run more efficiently and

an organization that is more politically

sophisticated and influential in Austin. Mygoal was to continue this process bytightening some of our organizationalprocedures this year. In running a

volunteer organization such as TPA,

policies can sometimes subtly change from

year to year. In the orientation for the new

board members this year, we discovered that

the bylaws and the policies and procedures

were not always in agreement with one

another. Also, with the yearly change in

leadership, some procedures are inadver-

tently altered. To rectify this situation, I

asked the Bylaws Committee to review the

bylaws and the policies and procedures and

to recommend changes that would align

them and also reflect what actually takes

place in the running of TPA.

The Bylaws Committee, a committee of

one, Dr. Ron Cohorn, worked long and

hard to find discrepancies and to

recommend changes. An example of achange that streamlined procedures was the

policy for nominating individuals for the

annual TPA awards. This process was socomplex that people frequently complainedthat it was just too difficult and too lengthy

to take the time to make a nomination.

Due to streamlining the nominationprocess, we had more people willing tomake nominations this year and we received

many strong nominations. Dr. Roberta

Nutt, Awards Committee chair, did a greatdeal of work on these procedures for theBylaws Committee.

On a personal note, my work on the

President’s New Freedom Commission onMental Health ended. The report was

2 Texas Psychologist WINTER 2003

FROM THE PRESIDENT

Deanna F. Yates, PhD

TPA P r e s i d en t

I suppose it is inevitable that as I write my last president’s column I would reflect on the happeningsof the year. It does not seem like long ago I was writing my first column and looking forward to myyear as president. Being a legislative year, it was expected to be a very busy and challenging year.Legislative years typically add so much to our agenda, and it was this year’s legislative agenda thattook center stage for several months.


published and finally made public in July.Some commisioners feared that the reportwould not be well received by many of thestakeholders or that it would sit on a shelfgathering dust somewhere rather thanbeing implemented. So far we have beenvery happy with the response. I have notheard anything negative about the reportand providers and consumer groups alikehave given us very positive feedback. Nowthe implementation is being planned.

While we hope that Texas is a demon-stration state for the implementation of theCommission’s recommendations, Mr.Charles Curie, the administrator ofSAMHSA, has been given the task ofevaluating the report and implementing

recommendations at the federal level. It is

an honor for me to be able to bring Mr.

Curie to Dallas to be the keynote speaker at

this year’s Convention. He will have the

most up to date information on the

implementation of the Commission’s

recommendations and I hope that many of

you will be there to hear him. In addition

to Mr. Curie’s address, our Program

Committee, chaired by Dr. Pat Ellis, has

put together a superb lineup of

presentations for this year’s convention

which is just around the corner. There

should be something for everyone so I

hope to see you in Dallas.

This has been a year fraught with

excitement, challenge, and frustration.

Nevertheless, I believe TPA is on its way to

being even better prepared to face thechallenges that lie ahead. I leave TPA incapable hands and expect to see the

organization continue to grow stronger and

wiser. I am happy to have had theopportunity to serve as your president thisyear and look forward to a successful future

for TPA and the practice of psychology.

Then when paying, $27 will be deducted from any program you select, including our $27 courses!

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✯

Special ThanksNo event of the magnitude of the TPA Annual Conventioncan be possible without the dedicated and oftenunappreciated work of volunteer members. They arecommitted to insuring that your annual convention willbe the best educational experience possible. Their loyaltyand dedication to this endeavor are vital contributionsthat add value to memberhip in TPA.

Should you bumpinto any of thecommitteemembers listedhere, please take amoment to thankthem.

Patrick J. Ellis PhD (Chair) — HoustonSharon Brown, PhD — Houston

Stacey Bourland, PhD — HoustonMichael Flynn, PhD — Denton

Tom Gray, PhD — VernonStephen McCauley, PhD — Houston

Suzanne Mouton-Odum, PhD — HoustonDean Paret, PhD — Burleson


That is what many of our members

think about the future of this

profession. They think that they

can just get up and go on about their

normal activities and everything will be

provided for them.

Over the last several issues, I have

reported the importance of our Sunset

review, which will take place in 2005. I have

told you about the committee and the

members who will be leading this effort. We

are not only focusing our efforts on Sunset,

we are also revising TPA bylaws and the

policy and procedures manual, discussing

with consultants how to position TPA for

the future, and learning how to gain a

group health insurance program for ourmembers. Needless to say, we have LOTShappening.

So who exactly is doing all the work for

TPA during this monumental time? Well,only 2.6 percent of the entire membershipserves on committees, task forces and TPA’s

Board of Trustees. So, out of 1,473

members we have only 39 working toadvance TPA’s initiatives. Those 2.6 percentactive members are from:

Active Members Serving on Committees/BoardsHouston . . . . . . . . . . . . . .25%

Austin . . . . . . . . . . . . . . . .17% Denton . . . . . . . . . . . . . . .10%

Dallas . . . . . . . . . . . . . . . . .5%

San Angelo . . . . . . . . . . . . .5%

San Antonio . . . . . . . . . . . .5%

Beaumont . . . . . . . . . . . . . .5%

Ft. Worth . . . . . . . . . . . . . .3%

Conroe . . . . . . . . . . . . . . . .3%

Big Spring . . . . . . . . . . . . .3%

Sugarland . . . . . . . . . . . . . .3%

Burleson . . . . . . . . . . . . . . .3%

El Paso . . . . . . . . . . . . . . . .3%

Lubbock . . . . . . . . . . . . . . .3%

Vernon . . . . . . . . . . . . . . . .3%

Huntsville . . . . . . . . . . . . . .3%

Waco . . . . . . . . . . . . . . . . .3%

Compare this involvement with theoverall demographics of TPA. Out of our

entire membership, 25 percent are from

Houston, while 16 percent are from Dallas,15 percent from Austin and 10 percentfrom San Antonio.

2003 DemographicsHouston . . . . .367 . . . . . .25%

Dallas . . . . . .238 . . . . . .16%

Austin . . . . . .220 . . . . . .15% San Antonio . .144 . . . . . .10% Ft. Worth . . . . .54 . . . . . . .4%

Other . . . . . . .450 . . . . . .30%

So it becomes clear that a majority ofactive members come from the larger cities,

but we also know that you can participate

in TPA in another way—your financial

support. Out of all the dues and PAC

revenue we received this year, 50 percent

came from members in Houston, Dallas,

San Antonio or Austin.

TOTAL DUES/PAC REVENUEHouston . . . . . . . . . . . . . . . .19%

Dallas . . . . . . . . . . . . . . . . . .10%

Austin . . . . . . . . . . . . . . . . . .13%

San Antonio . . . . . . . . . . . . . .8%

As TPA continues to position itself as a

political force in the state legislature, one

factor that keeps us “politically involved” is

the PSY-PAC contributions. I want to

provide a few more statistics for you to

consider. Out of all the contributors for thisyear, 63 percent came from the five majorTexas cities, yet only 36 percent of the total

dollars collected came from these folks.

What that indicates is that members outsideof the large cities are being active with theircontributions.

Another form of active participation in

TPA is your attendance at the TPA AnnualConvention. Out of the total conventionattendees, members from the rural areas of

the state represent the larger turnout, with

members from Houston representing thelargest number of attendees from the largercities.

Continued on page 6

Success Before Work . . .David White, CAE

TPA Executive Director

I want you to imagine getting up this morning and not having to go to work. In essence, you are ableto get up and provide a very comfortable living without doing much work at all. You might have investedwisely in the past and are currently reaping the benefits of your past successes, but during that initialtime you did have to work. Think of what it would be like NEVER to have to work and have everythingprovided for you…

FROM TPA HEADQUARTERS


Convention HistorySo, there you have it: an overview of the active members within

TPA. If you are not in one of these categories, I hope you make acommitment beginning NOW to become involved. Let’s change thetrend and WORK TO BE SUCCESSFUL. We need your time,energy, financial resources and your encouragement.

ACT NOW…See you at the TPA convention in Dallas on November 6-8.

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Continued from page 4

WINTER 2003

Council of Representatives

Joseph C. Kobos, PhD

As Roseanne Roseanna Danna would say, “If it’s not one thing, it’s another.” At the last Council meeting,we struggled in the snow and many were stranded. In August, we worried about how many would come toToronto for the Council meeting and the Annual Convention. This time the culprit was SARS. When the WorldHealth Organization declared Toronto off limits to travelers in April, all the listservs were concerned aboutwhether to cancel the convention and if individual members would attend even if theconvention were held.

Eventually, Toronto was taken off the WHO list and APA

decided to hold the meeting. Canceling the meeting would be

very costly because of contract penalties and moving the

convention was impossible on such short notice. The decision to go

forward was wise. While attendance revenues were down, the drop was

nowhere near as grim as anyone predicted. APA leadership, which

included our new CEO Norman Anderson and his team, and everyone

in convention planning all deserve kudos. After thoughtful deliberation

and a review of the data, they followed the advice of that old

philosopher, Yogi Berra, “When you come to a fork in the road, take

it.” In the end, perhaps a dozen or more did not attend Council and

either left an empty seat or found replacements.

Norm Anderson continues to settle in as CEO. He gave an excellent

chronology of the issues involved in making a difficult decision and

described the very human and scientific process of making the decision

to go ahead with the convention. In addition to talking about APAfinances, he laid out his capital hill agenda, which included mentalhealth parity, graduate psychology education, and supporting NIH and

other funding for psychosocial research. He described one legislator’s

efforts to use a line item approach todelete funding for sexual behaviorresearch. In an unprecedented

maneuver, the specific research and its

funding ID number were listed in afunding bill. This process would removereview and funding authority from the

NIH. APA’s efforts were successful in

turning back the tide, but it was a closevote and similar efforts are anticipatedin the future.

The big news was the budget and

APA finances. Under the very able

leadership of CFO Jack McKay, APA

refinanced its two buildings. This

freed up money so we will no

longer have cash flow

difficulties. The Finance

Committee continues to

recommend a conser-

vative budgeting pro-

cess and the Board

of Directors and

Council

affirmed the

process, with

one exception

— Council

Texas Psychologist 7


recommended and voted the resumption of acombined Board/Committee, which meansan expenditure of $200K. APA is poised to be$400K in the black in 2004 — a remarkableturnaround from the past several years.

Kurt Salzinger has announced hisintention to leave as head of the ScienceDirectorate. We are currently looking for anew director.

CRSPPP also recommended — andCouncil approved — the renewed recog-nition of clinical neuropsychology as aspecialty in professional psychology.

Look for an APA ballot on amending thebylaws. The issue is whether any bylawchange should be accompanied withclarifying information. Currently whenever a

change in bylaws is presented to the

membership, Council votes on whether

pro/con statements should accompany the

proposed change. Over the years, any

proposed bylaws change with pro/con

statement would be voted down. However,

some thoughtful Council members reasoned

that it is anti-democratic and anti-intellectual

not to include pro/con statements orinformation about any issue that requires avote, because only an informed electorate canmake reasoned decisions. Look for the ballotand also see whether a pro/con statementaccompanies it. Much thoughtfuldeliberation and parliamentary consultationwent into the debate and decision.

In the opening memorial for deceasedmembers, Gladys Guy Brown of Dallas wasacknowledged. Dr. Brown was one of the firstindependent practitioners in Texas. I had theopportunity to interact with her on severaloccasions and she offered very positiveencouragement. Dr. Brown was also one ofthe early Diplomates of the American Boardof Professional Psychology. She represented

the highest standards of our profession.

Congratulations to M. David Rudd of

Baylor University and TSBEP who was

elected to Fellow status in Division 12,

Clinical, and to Dee Yates of San Antonio

who was elected to Fellow status in Division

55, Pharmacotherapy.

Welcome to Bob McPherson, ourProfessional Affairs Officer, who will becomethe Texas Representative to APA Council.Our interests are in good hands, but morehands would be better. Vote 10 for Texas, andlet’s get two representatives from Texas.

This is my last column as APARepresentative. I have enjoyed serving youand representing Texas Psychology interestson Council. My formal tenure ends inDecember but I received my certificate inAugust, which tells you something. Workingwith the TPA Board of Trustees has been afun and stimulating experience. Psychologyin Texas is an exciting and vibrant profession.I urge you to get involved in your localcommunity with your elected representatives

and in your professional organization. You

can make a difference. I will see you at the

TPA Convention in Dallas. If all goes as

planned, my son and his wife who live in

Dallas will be delivering us another

grandchild at that time. Happy trails. ✯


Many of our former leadersattended and were recognized

for their efforts and continued

support. We were also particularly fortunate

to hear Dr. Reuven Baron, an international

expert on Emotional Intelligence, discuss

his research and its application to practice.

At the end of the meeting, Dr. Patrick Ellis

presented the 2003 Media Award to

television personality Jerome Gray, who was

very gracious in his acceptance of the award

for his work on the “My Family/Your

Family” weekly program on Channel 11

(CBS).

In July, HPA members and quite a few

potential new members gathered together

at a luncheon in the first of a series of

planned talks aimed at those in our

association who are in private practice or

are considering it as a career option in thefuture. This series of talks by business

professionals, attorneys, and seasoned

psychologists is aimed at informingpsychologists about the ins and outs ofrunning a small business. At the July

meeting, a panel composed of a certified

public accountant and a business marketingspecialist addressed many of the issuesinvolved in the private practice business

such as developing a marketing plan and

strategy, tax issues, etc. Topics selected to becovered in future gatherings will addressmany of the issues psychologists never

learned in graduate school but need to

know about to survive and prosper in thecurrent economic climate. The series will

continue later this fall with a networkingbreakfast and a talk by a local attorney who

will alert us to the legal pitfalls of private

practice. Plans are also underway to address

our members’ needs for meeting the new

TSBEP requirement of continuing

education hours in ethics.

On a serious note, HPA members came

together to voice their concerns during the

summer after learning of actions by the

Texas Legislature directly affecting the

provision of mental health care here in

Houston as well as all over Texas. Local

psychologists working in public agencies

and private practitioners who service adult

clients with Medicaid and who will be

affected by these changes alerted us. We

contacted TPA leaders who were quick to

respond to our requests for information.

Armed with information gathered by TPA,many of our members organized to get the

word out about the need to attend hearings

in Austin. Others wrote letters of protestand contacted legislative members aboutthe impact to the public. With the

upcoming city council elections and

mayor’s race, HPA is also planning tocontinue its political activeness and to makeour voice heard with regard to mental

health issues in our city. Our legislative

chairs are in the process of arranging briefvisits by candidates for city offices at ourupcoming fall luncheons in September and

October to discuss their views regarding

city services affecting the mental healthprovider community.

As the summer comes to an end, HPAmembers will have an opportunity at our

next luncheon in September to hear Dr.

Michelle York from Baylor College of

Medicine discuss her research and describe

practice issues with regard to patients with

Parkinson’s disease. We will also welcome

back our members and greet the psychology

interns who are new to the city and are

beginning their internships at the five APA

accredited internship sites located at school

districts, hospitals, and medical schools

within Houston. We have many exciting

plans for this new year including efforts to

expand our membership and increase our

visibility within the community. Our

programming chairs are working hard to

develop a program of speakers who will

discuss topics of interest that will entice our

members to become active and regularlyattend our luncheons. Plans are already

underway for our holiday party and other

social events that will provide networkingopportunities and camaraderie. In addition,HPA committees are developing

continuing education workshops of interest

to local psychologists and the mental healthcommunity. We are also working to bringin a nationally-recognized speaker for the

Annual Spring Conference scheduled for

May of 2004. To stay in the know, be sureand check out our web sitewww.hpaonline.org and our monthly

newsletter filled with the latest about what

is happening here in Houston.

LAS NEWS From the Houston Psychological Association

Julie Landis, PhD, HPA President

Members of the Houston Psychological Association (HPA) began the new fiscal year with a bow to ourpast by inviting previous presidents and officers of HPA to the June luncheon meeting to celebrate thecontinuation of our organization as a vital network for professional psychology in Houston.

✯


According to the Texas Higher

Education Coordinating Board figures

(THECB, 2003), Texas public institutions

of higher education award over 600 master’sdegrees in psychology every year. When

added to the psychology master’s degrees

awarded by Texas private institutions ofhigher education, Texas clearly is a majorproducer of master’s level psychology

graduates. Also, according to the THECB,

over the past five years more than two-thirds of the psychology master’s graduatesof Texas public universities obtain their

degrees in clinical, counseling, or school

psychology programs. The Texas publicinstitutions of higher education that awardthe most master’s degrees in psychology are

presented in Table 1. Interestingly,

counseling psychology programs producesome three times more graduates than

Career Trends for Texas Master’s Level Psychology Graduates

Emily Sutter, PhD; Howard Eisner, PhD; and Leslye Mize, PhDUniversity of Houston — Clear Lake

ABSTRACT

Texas produces hundreds of master’s level psychology graduates each year. What have their careerexperiences been? Since 1981, the authors have periodically surveyed all graduates of theprofessional psychology master’s level programs at the University of Houston-Clear Lake to determinethe graduates’ career experiences. In the spring of 2003, surveys were mailed to 669 graduates.Survey questions investigated licensure, employment, salary, and the perceived effects of managedcare on the graduates’ work. The survey produced a 48% return rate. Results suggest that basicmental health service activities have not changed much over the past 20 years but have adapted tojob market conditions. Diagnostic work for school psychology graduates in school districts remains astaple, as does psychotherapy in private practice and outpatient settings for graduates of the clinicaland family therapy programs. As a group, the school psychology graduates tended to be better paid,although respondents earning the highest incomes were psychotherapists in long-term privatepractice. Licensure has become essential over the decades, with the professional counselors license(LPC) the most popular credential. Managed care has affected the psychotherapists much more thanthose doing research or working in school districts, but not enough to drive practitioners out of thefield. Overall, the employment rate for master’s level graduates remains very high.

Table 1

Texas public universities granting the most psychology master’s degrees

Graduates of only Graduates of all Clinical/Counseling/

TX Public Universities Psych. Programs* School Programs

Prairie View A&M 172 170

Univ. of Houston-Clear Lake 50 30

Sam Houston State Univ 46 43

Southwest Texas State Univ 38 37

Stephen F. Austin 31 23

Statewide Total 633 446

Note: Figures are mean numbers of degrees awarded/year, 1998-2002.

* These figures include clinical/counseling/school graduates.


clinical and school psychology programscombined. This fact mirrors figuresobtained at the national level by theAmerican Psychological Association (APA,1999). Clinical, counseling, and schoolprograms are practitioner-trainingprograms that usually lead to licensure inmental health professions. Graduates ofprograms other than psychology also oftenearn such licensure. For instance, programsin counseling and guidance, studentcounseling, and counseling education arefrequently offered by schools of educationand lead to the MEd, as opposed to the MSor MA in psychology. Over 800 of thesecounseling degrees are awarded each year byTexas public institutions alone (THECB,

2003). Other mental health practitioners,

such as marriage and family therapists,

come from even more diverse academic

program areas, such as human development

or home economics. In sum, Texas produces

well over 1,000 potential master’s level

mental health practitioners every year.

Within this very large cohort of

potential mental health practitioners, where

do the graduates of master’s level

psychology programs find their career

identities? Except for the American

Psychological Association data (APA, 1999)

that describes career experiences of new

master’s level psychology graduates at the

national level, there is little recent

information on this topic (Gehlmann,

1994; Lowe, 1997; MacKain, Tedeschi, and

Durham, 2002; Sutter, Mize, and Eisner,1994). One of the first mental healthcredentials for master’s level psychology

practitioners in Texas was the certification

for psychological associates, created withthe Psychologists’ Licensing Act of 1969.Over the years this certification was

replaced by a license for psychological

associates (LPA) to practice undersupervision. The 1980s and early 1990s sawthe introduction of new Texas licenses for

mental health practice, primarily the

professional counselors’ license (LPC), themarriage and family therapists’ license(LMFT), and the chemical dependency

counselors’ license (LCDC). The license forspecialists in school psychology (LSSP) wascreated by the Texas legislature in 1995. Itcredentials individuals to practice schoolpsychology only in Texas public schools andis not a license for private practice.

What trends have occurred in the careerissues of Texas master’s level psychologygraduates? What licenses are the mostpopular? Are these graduates readily able tofind employment and where do the jobsexist? What activities fill their workdays?How much do they earn? How have theybeen affected by managed care? And aretheir experiences similar to psychologymaster’s graduates in the rest of the nation?These career choices would seem of obvious

interest to the faculties of master’s level

psychology programs, to psychology

students themselves, and to the profession

of psychology as a whole. They are the focus

of this study.

To answer these questions, faculty at the

University of Houston-Clear Lake (UHCL)

surveyed the graduates of their three

professional psychology master’s programs

(clinical, school, and family therapy) in

1981, 1993, and again in 2003. Where

appropriate, each new survey has been

compared to the previous decade’s survey

results. Because they are new, the results of

the 2003 survey are presented here in more

detail than the past surveys. The

information concerning trends in career

choices not only assists in curriculum

development within academic programs,but also provides a window into the mentalhealth profession at the master’s level.

Because UHCL is one of the major

producers of these professionals in Texas,the career choices of these graduates mayhave implications for mental health practice

in the state as a whole.

MethodParticipants

The authors surveyed all graduates of the

UHCL professional psychology master’sdegree programs (clinical, school, andfamily therapy). These professional

programs are specifically designed toprepare graduates for licensure andprofessional mental health practice. All theprofessional program areas areapproved/accredited by their respectiveaccrediting agencies. The AmericanAssociation for Marriage and FamilyTherapy (AAMFT) accredits the FamilyTherapy program; the National Associationof School Psychologists (NASP) approvesthe program for School Psychology; and theClinical Psychology program meets thestandards of the Council of AppliedMaster’s Programs in Psychology(CAMPP). The programs all require morethan 60 semester credit hours and involveextensive internships. The average age of the

students is 36, and the majority are white

females.

QuestionnaireThe questionnaire contained 16

questions, mostly in multiple-choice

format. Basic questions about licensure and

employment experiences were the same

each decade with minor updating to reflect

new licenses or practice conditions. Space

was available at the end of the survey for

participant comments.

ProcedureThe study was approved by the institution’s

IRB and the questionnaires were mailed to all

professional psychology graduates. A stamped,return-addressed envelope was included to

enhance the response rate. Results were

tabulated and subjected to chi square analyses.Results reported as significant employed analpha of .01.

ResultsSurvey Return Rate

The current survey was mailed in

January 2003 to all 669 graduates of theClinical Psychology, School Psychology, and

Family Therapy programs at UHCL.Completed surveys were returned by 317

graduates, for a 48% response rate.Response rates were fairly consistent for the

three program areas. Of those who returned


the survey, 310 indicated their primarymajor. Some 115 (37%) were graduates ofthe Clinical Psychology program, 128(41%) were from Family Therapy, and 67(22%) were from School Psychology. TheSchool Psychology program is the smallestand the newest of the programs so thesmaller number responding was notunexpected. Some 10% of the respondentsgraduated between 1976 and 1985; 51%graduated between 1986 and 1995; and theremainder (39%) graduated between 1996and 2002. In general, the return rateappears sufficient to draw meaningfulconclusions from the responses.

Acceptance into Doctoral ProgramsA question newly included in the

current survey asked if the respondent had

been accepted into a doctoral or other

advanced professional degree program since

graduation. Since the three programs are

designed to be “terminal” professional

master’s degrees, it was surprising to learn

that 16% of the master’s graduates had

been accepted into doctoral or other

advanced professional degree programs.

Clinical, counseling, and school psychology

doctoral programs were the most popular.

There was no significant difference among

the three UHCL programs in terms of

acceptance rates into doctoral programs. A

chi square test did show a highly significant

relationship between acceptance into

doctoral programs and time of graduation:the longer the interval since receiving the

professional psychology master’s degree, the

more likely it was that the respondent hadbeen accepted into an advancedprofessional degree program.

Employment RateThe number of graduates employed

outside the home for pay dropped very

slightly from the survey in 1993 (90%) to

the 2003 survey (87%). Only 10individuals indicated they were looking forwork, yielding a 3% unemployment figure.

This is identical to APA’s findings for new

master’s graduates (APA, 1999). Most

(90%) of the employed UHCL graduateswork more than 20 hours per week. This isslightly better than the AmericanPsychological Association’s (APA) figuresfor master’s level employment, but the APAfigures considered only recent graduates(APA, 1999). Of the 13% in the currentsurvey who were not working, 25%indicated they were looking for work; 22%indicated they were not interested in workat this time; 28% indicated they wereretired; and the rest gave various otherreasons for not being employed. It is verydifficult to draw unemployment rateimplications from these data for master’slevel graduates because of the currentrelatively high unemployment figures for

the nation in general (6.2%unemployment). However, if UHCLgraduates are typical of the entire state,then Texas master’s level psychologygraduates fare very well in using theireducational training to obtainemployment.

Licenses ObtainedOf particular interest is the information

concerning the licenses obtained by theUHCL master’s graduates across the threedecades. These data are presented in Table2. Because 16% of the respondentsindicated they had been accepted intodoctoral programs, it is not surprising to seetwo new licensure categories this year, the

Table 2

Credentials obtained by UHXL professional psychology graduates

Credential 1981 1993 2003(N=109) (N=237) (N=317)

LPA 17% 12% 7%

(Psychological Assoc.)

LPC NA 51% 53%

(Professional Counselor)

LMFT NA 35% 31%

(Marriage & Family Therapist)

LSSP NA NA 19%

(Specialist in School Psych.)

LCDC NA 16% 6%

(Chemical Dependency Counselor)

LP no data no data 5%

(Psychologist)

MD no data no data 2%(Medical Doctor)

Other no data no data 7%

None 83% 24% 14%

Note: Percentages exceed 100 because some respondents hold multiple credentials.


Licensed Psychologist (LP) and the MedicalDoctor (MD). The responses in the “other”category generally specified a credential thatwas offered by a professional association asopposed to a license. Licenses were notexamined in the APA national survey sincelicensing is done at the state level.

The professional counselor’s license(LPC) remains the most popular choice(53%) of the 2003 respondents, with 31%of the 317 respondents obtaining thelicense for marriage and family therapists(LMFT). These figures are very similar tothe results from the 1993 respondents. TheUHCL practitioner programs weredesigned with the assumption that mostgraduates would become psychological

associates. However, results suggest that the

percent seeking licensure as an LPA

continues to decline over the decades, with

only 7% of the 2003 respondents

possessing the LPA. New since the 1993

survey is the specialist in school psychology

license (LSSP), with 19% of the

respondents obtaining this license. As more

types of licenses have become available and

as more legal restrictions appear for

individuals attempting to practice in the

mental health field without a license, it is

not surprising to see the percent of

graduates with no license steadily declining

from 83% in 1981 to 14% in 2003.

Employment SettingsWhen asked about their employment

setting and work activity, only those 2003respondents (N=219) who responded to thequestions and who indicated they worked

more than 20 hours per week were included

in the data analyses. From the responses ofthese full-time employed individuals, somepossible trends appear (see Table 3). Since

the demise of psychiatric hospitals in the

early 1990s, only 6% of the respondentswork in inpatient mental health settings.Some of these were specified as prison

hospitals or nursing homes. An increasing

proportion of the graduates now work inpublic schools as well as in outpatientsettings such as mental health agencies. The

spike seen in private practice settings duringthe 1980s seems to have diminishedsomewhat by 2003. In an attempt to more

thoroughly explore the sites involved in the“other” responses, these answers were re-examined and categories for higher

Table 3

Primary employment settings of UHCL professional psychology graduates

Setting 1981 1993 2003(N=109) (N=237) (N=219)*

In-patient 19% 6% 6%

Out-patient agency 18% 14% 22%

Public school 13% 12% 25%

Private practice 15% 30% 24%

University no data no data 6%

Business/Industry no data no data 3%

Medical facility no data no data 5%

Other 35% 38% 9%

*Only data from those employed full time were considered here.

Table 4

Primary work activity of UHCL professional psychology graduates

Nature of work 1981 1993 2003

Psychotherapy 29% 48% 41%

Diagnostics/assessment 14% 6% 22%

Case management 17% 6% 15%

Administration 17% 6% 9%

Teaching 12% 3% 2%

Research no data no data 3%

Consulting no data no data 3%

Other 11% 31% 5%


education, business, and medical facilitieswere included in Table 3 for the 2003respondents. It was also interesting to notethat when the sites were examined in termsof the degree program of the respondent,significant differences emerged. Asexpected, those with school psychologydegrees were employed primarily in publicschools, while those with clinical or familytherapy degrees were employed primarily inprivate practice and outpatient settings.Date of graduation also showed asignificant relationship to employmentsetting, with those receiving degreesbetween 1978-1985 being employed morefrequently in private practice andinstitutions of higher education (58% and

21% respectively) than those graduating

from 1986 to 1993 (29% and 8%), or those

graduating more recently from 1994-2002

(12% and 4% respectively).

Work ActivityWhen queried about the nature of their

work, the current respondents reveal a slight

shift away from psychotherapy and into

more diagnostic jobs or case

management/short term counseling roles.

Again, in an attempt to provide more

specific data, the “other” responses were

examined. Research and consulting

emerged as two additional job categories.

Table 4 compares the work activities during

the three different survey dates.

A significant relationship was found

between the license obtained andrespondents’ primary work, with LSSPsdoing diagnostic work while LPCs and

LMFTs were more involved with

psychotherapy. Further, a significantassociation was found between employmentsetting and job activity. Those employed in

the schools were primarily involved with

diagnostic work and those employed inprivate practice or outpatient settings didpsychotherapy primarily.

EarningsHow much money do the graduates

make? Because of inflation, no attempt was

made to compare incomes across thedecades. However, since income is a veryimportant variable, it was examined in thisyear’s survey in a number of ways: degreeobtained, length of time from graduation,license, employment setting, and workactivity. Tables 5 and 6 present some ofthese data.

As a group, those with the schoolpsychology degree tend to be paid better.This finding was consistent with results ofthe APA survey at the national level (APA,

1999). Some 86% of the school psychologygraduates earned above $40,000 per year.Clinical psychology graduates fared less wellwith 65% earning above $40,000. Familytherapists came in last, with approximately59% of their graduates earning above$40,000. Yet, it was this same practitionergroup (family therapy) that had the greatestpercentage of graduates earning above$70,000. As one might expect, earningsvaried by date of graduation, with graduatesearning more money the longer they were

Table 5

Earnings of UHCL professional psychology graduates by program area

Amount Clinical School Family Tpy. Total(N=75) (N=55) (N=87) (N=217)

Under $30,000 15% 7% 18% 14%

$30,000 - $39,999 20% 7% 24% 18%

$40,000 - $49,999 32% 49% 16% 30%

$50,000 - $59,999 11% 22% 16% 16%

$60,000 - $69,999 9% 9% 9% 9%

Over $70,000 13% 6% 17% 13%

Table 6

Employment of UHCL professional psychology graduates earning over$70,000

Setting % Work activity %

In-patient 0% Psychotherapy 63%

Out-patient agency 7% Diagnostics 7%

Public school 7% Case Management 0%Private practice 48% Administration 7%

University 15% Teaching 4%Business/Industry 7% Research 4%

Medical facility 4% Consulting 4%

Other 12% Other 11%


in the field (i.e., the further out theirgraduation date). As a group, LSSPs (schoolpsychology) earned more than LPCs andLMFTs (clinical and family therapy). Thisis particularly noteworthy since the schoolpsychology yearly incomes are normallybased on a 10-month academic year asopposed to clinician and family therapyincomes that are normally based on a 12-month calendar year.

A separate analysis was done ongraduates earning over $70,000 (see Table6). A substantial number of theseindividuals were involved in the privatepractice of psychotherapy (and were LPCsor LMFTs who had been in the professionfor a long time since graduation).

Managed CareFinally, the 2003 survey queried the

respondents about the effects of managed

care on their work. Since the managed care

phenomenon arose in Texas after the 1993

survey was conducted, no comparison

across decades was possible. Graduates were

asked how much managed care currently

affected their work and what they

anticipated the effects would be in another

five years. Results are presented in Table 7.

The school psychology graduates report

being affected little or not at all by managed

care, while the clinical and family therapy

graduates report being much more affected.

The differences among these three groups

were highly significant. This difference is

equally apparent when the professions wereasked to predict how much managed carewould affect them five years hence. When

these responses to managed care were

examined by types of licenses possessed, itcame as no surprise that the LSSPs werenegligibly affected, but the LPCs and the

LMFTs were much more affected. The

difference was again highly significant.Similarly, those reporting being leastaffected by managed care worked in school

settings (only 2% reported being very much

affected by managed care) and diddiagnostic work (54% reported not beingaffected at all). Some 83% of researchers

also reported not being affected at all bymanaged care. Those working in privatepractice or business reported being verymuch affected by managed care (64% and67% respectively). Some 52% ofpsychotherapists reported being very muchaffected by managed care.

When asked in what specific waysmanaged care affected their work,respondents gave multiple responses. Table8 shows that for those indicating they wereaffected, increased paperwork was the maincomplaint. Other concerns were a decreasein length or amount of services provided toclients and a decrease in fees charged.Interestingly, more respondents reportedthat managed care increased their caseload

rather than decreasing their number of

clients.

DiscussionThe present survey data, when

compared with data collected over the pasttwo decades, suggest that graduates ofprofessional psychology master’s levelprograms are increasingly seeking licensureand seem to be increasingly diversifyingand specializing to meet the needs of aconstantly changing job market. Graduatestended to flock to private practice in the1980s when liberal insurancereimbursement for services prevailed. Afterthe advent of managed care, fewergraduates pursued the private practice ofpsychotherapy. Clearly employment ofthese master’s level graduates in the mentalhealth field remains high. Most are

employed full time with the vast majority

employed in the mental health field in

which they trained. Those in school

psychology seem to benefit from strong job

Table 7

Perceived effects of managed care on UHCL professional psycohlogygraduates now and in five years

PROGRAMS

Clinical School Family Therapy

Effects Now

Very Much 39% 2% 45%

Somewhat 13% 13% 13%

Very little 23% 27% 19%

None 25% 58% 23%

Effects in 5 years

Very Much 56% 4% 35%

Somewhat 14% 19% 34%

Very Little 10% 41% 17%

None 20% 36% 14%


demand, doing primarily diagnostic work,with salaries between $40,000 and$60,000. They report being affected littleby managed care. Those in clinical andfamily therapy programs clearly prefer theLPC and LMFT licenses to the LPA, andfind employment in outpatient agencies orprivate practice. Those in outpatientagencies generally earn less than $40,000per year, while individuals in privatepractice show the widest range of incomes.However, of the respondents earning morethan $70,000 per year, most are in privatepractice and have been there for manyyears. Psychotherapy is the primary activityof the clinical and family therapy graduatesand managed care affects these practitioners

much more than the school psychology

graduates. These practitioners expect

managed care to have a similar, substantialimpact on their professional activities overthe next five years.

The results suggest that while Texasproduces large numbers of master’s levelprofessional psychology graduates eachyear, these individuals continue to findemployment in the mental health field withmost earning over $40,000 per year.Presumably this success speaks to thequality of their work and theircontributions to the lives of those seekingmental health services.

ReferencesAmerican Psychological Association

Research Office (Update 1999). Auguste,

R.M., Wicherski, M., and Kohout, J.L.

1996 Employment Survey: Psychology

Graduates with Master’s, Specialist’s, andrelated Degrees. APA Online. www.apa.org.

Gehlmann, S.C. (1994). Employmentsurvey: Psychology graduates with master’s,specialist’s, and related degrees. Office ofDemographic, Employment andEducational Research, EducationDirectorate, American PsychologicalAssociation, Washington, D.C.

Lowe, R.H. (Spring, 1997).Employment realities and possibilities formaster’s level psychological personnel.Journal of Psychological Practice, 3(2), 47-54.

MacKain, S.J., Tedeschi, R.G., &

Durham, T.W. (August, 2002). So what are

master’s-level psychology practitioners

doing? Surveys of employers and recent

graduates in North Carolina. ProfessionalPsychology: Research & Practice, 33(4), 408-

412.

Sutter, E., Mize, L., & Eisner, H.

(October, 1994). Whither graduates of

master’s psychology programs? The TexasPsychologist, 5-9.

Texas Higher Education Coordinating

Board, Degrees Awarded Data (Profile

020), Masters Degrees Awarded by

Curriculum Area (Report 060), Psychology(Element 4200000000) and Coun

Educ/Std Con & Guid Srvc (Element

1311010000). www.thecb.state.tx.us/netvisual/menu.htm.

Table 8

Ways in which managed care affects UHCL professional psychologygraduates

Effect % (N=220)

Increases # of clients 19%

Decreases # of clients 11%

Increases paperwork 46%

Increases services provided to clients 5%

Decreases services provided to clients 29%

Increases fees charged 5%

Decreases fees charged 27%

Increases overhead expenses 18%

Decreases overhead expenses 1%

No effect 34%

Other responses 11%

Note: Percentages exceed 100 because multiple responses were allowed.

✯


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Empirically validated treatments is a

difficult topic for a practitioner to

discuss with clinical scientists. In

my attempts to discuss this informally, I

have found that some clinical scientists

immediately assume that I am anti-science

and others emit a guffaw, asking

incredulously, “What, are you for

empirically-unsupported treatments?”

McFall (1991, p. 76) reflects this

perspective when he divides the world of

clinical psychology into “scientific and

pseudoscientific clinical psychology,” and

rhetorically asks, “What is the alternative

[to scientific clinical psychology]?

Unscientific clinical psychology” (see also

Lilienfeld, Lohr, & Morier, 2001).

Thus, there are some ardent clinical

scientists (e.g., McFall and Lilienfeld) whoappear to subscribe to scientific faith and

believe that the superiority of the scientific

approach is so marked that otherapproaches should be excluded. Since this isa matter of faith rather than reason,

arguments would seem to be pointless.

Nonetheless, clinical psychologists haveargued over it for the last eight years.Punctuating these interactions from the

practitioner perspective, the controversy

seems to stem from the attempts of someclinical scientists to dominate the discourseon acceptable practice and impose very

narrow views of both science and practice.

Let’s start with a brief recapitulation of

the events. Division 12, under the

leadership of then President David Barlow,

formed a Task Force “to consider methods

to educate clinical psychologists, third party

payors, and the public about effective

psychotherapies” (APA Division of Clinical

Psychology, 1995, p. 3). The Task Force

came up with lists of “Well-Established

Treatments” and “Probably Efficacious

Treatments.” Not surprisingly, the lists

themselves emphasized short-term

behavioral and cognitive-behavioral

approaches, which lend themselves to

manualization; longer term, more complex

approaches (e.g., psychodynamic, systemic,

feminist, and narrative) were not well

represented.

The empirically validated treatments

movement has had quite an impact on

practitioners. It provided ammunition tomanaged care and insurance companies intheir efforts to control costs by restricting

the practice of psychological health care

(Seligman & Levant, 1998). It has alsoinfluenced many local, state, and federalfunding agencies, which now require the

use of empirically validated treatments.

Moreover, this movement could have aneven greater impact on practitioners in thefuture. For example, it could create

additional hazards for practitioners in the

courtroom if empirically validatedtreatments are held up as the standard ofcare in our field. Further, adherence to

empirically validated treatments could

become a major criterion in accreditation

decisions and approval of CE sponsors, as

the Task Force has urged (APA Division of

Clinical Psychology, 1995, p. 3). Some

clinical scientists have gone so far as to call

for APA and other professional

organizations “to impose stiff sanctions,

including expulsion if necessary,” against

practitioners who do not practice

empirically validated assessments and

treatments (Lohr, Fowler & Lilienfeld,

2002, p. 8).

Given all of this fallout, it should be no

surprise that the Task Force report was soon

steeped in controversy. Critics argued first

and foremost that the Task Force used a

very narrow definition of empirical

research. For example, Koocher (personal

communication, 7/20/03) observed that“‘empirical’ is in the eye of the beholder,and sadly many beholders have very narrow

lens slits. That is to say, qualitative research

[and] case studies…have long been avaluable part of the empirical foundationfor psychotherapy, but are demeaned or

ignored by many for whom ‘empirical

validation’ equates to ‘randomized clinicaltrial’ [RCT]. In addition, a randomizedclinical trial demands a treatment manual

to assure fidelity and integrity of the

intervention; however, the real world ofpatient care demands that the therapist(outside of the research arena) constantly

The Empirically Validated Treatments Movement:A Practitioner Perspective 1

Ronald F. Levant, EdD, ABPP

I would like to weigh in on the issue of what has been called, sequentially, “empirically-validatedtreatments” (APA Division of Clinical Psychology, 1995), “empirically-supported treatments” (Kendall,1998), and now “evidence-based practice” (Institute of Medicine, 2001).


modify approaches to meet the idiopathicneeds of the client…Slavish attention to‘the manual’ assures empathic failure andpoor outcome for many patients.”

Furthermore, Seligman and Levant(1998) argued that, whereas efficacyresearch programs based on RCT’s mayhave high internal validity, they lackexternal or ecological validity. On the otherhand, effectiveness research, such as theConsumer Reports study (Seligman, 1995),has much higher external validity andfidelity to the actual treatment situation asit exists in the community. Additionaleffectiveness studies are needed and couldbe conducted by the Practice-ResearchNetworks that have recently appeared

(Borkovec, Echemendia, Ragusea, & Ruiz,

2001). Finally, others have pointed out that

many treatments have not been studied

empirically. There is a big difference

between a treatment that has not been

tested empirically and one that has not been

supported by the empirical evidence.

A few years later, John Norcross, then-

President of Division 29 (Psychotherapy),

countered by establishing a Task Force on

Empirically Supported Therapy Relation-

ships in 1999, which emphasized the

person of the therapist, the therapy

relationship, and the non-diagnostic

characteristics of the patient (Norcross,

2001). Lambert and Barley (2001)

summarized this research literature,

pointing out that specific techniques

(namely those that were the focus of thestudies underlying the Division 12 TaskForce report) accounted for no more than

15 percent of the variance in therapy

outcomes. On the other hand, the therapyrelationship and factors common todifferent therapies accounted for 30

percent, patient qualities and extra

therapeutic change accounted for 40percent, and expectancy and the placeboeffect accounted for the remaining 15

percent.

Westen and Morrison (2001) reported amultidimensional meta-analysis oftreatments for depression, panic disorder,

and GAD, in which they found that “themajority of patients were excluded fromparticipating in the average study,” due tothe presence of comorbid conditions (p.880). Approximately two-thirds of thepatients in the studies they reviewed wereexcluded, which seems like a highpercentage, but is actually a bit lower thannational figures for comorbidity.Meichenbaum (2003) noted that fewerthan 20 percent of mental health patientshave only one clearly definable Axis Idiagnosis. Thus, the vast majority of casesseen by practitioners do not meet the exactdiagnostic criteria used in the RCT’s thatestablished efficacy for various treatments.

Furthermore, the empirically validated

treatments on these lists have typically been

studied using homogeneous samples of

white, middle-class clients, and therefore

have not often been shown to be efficacious

with ethnic minority clients.

So what does this all mean? Suppose wehad lists of empirically validatedmanualized treatments for all DSM Axis Idiagnoses (which we are actually a longways away from). We would then havetreatments for only 20 percent of the white,middle class patients who come to ourdoors—namely those who meet thediagnostic criteria used in studies thatvalidated these treatments. That’s badenough, but that’s not all. In order to limitservices to only the 20 percent of white,middle class patients who come to us, theaverage practitioner would have to spendmany hours, perhaps years, in training tolearn these manualized treatments. If werestricted ourselves to use only manualized

treatments, we would be limiting our role

to that of a technician. In the end, these

treatments would only account for 15

percent of the variance in therapy outcomes

of these patients. One can readily see why


few practitioners embraced the empiricallyvalidated treatments movement.

My view is that although one ofpsychology’s strengths is its scientificfoundation, the present body of scientificevidence is not sufficiently developed toserve as the sole foundation for practice.Practitioners must be prepared to assess andtreat those who seek our services. To besure, we all get referrals of clients that wedecide to refer to others because we don’tthink that we are the best clinician for thatcase, but those who are in general practicehave to work with the clients that come tothem. Whether we operate from a singletheoretical or a more eclectic perspective,we bring to bear all that we know from the

empirical literature, the clinical case studies

literature, and prior experience, as well as

our clinical skills and attitudes, to help the

client that is sitting in front of us. This is

what is often referred to as clinical

judgement. Some condemn clinical

judgement as subjective. To them I say that

clinical judgement is simply the sum totalof the empirical and clinical knowledge andpractical experience and skill that cliniciansbring to bear when it is our job tounderstand and treat a particular and veryunique person.

Fox (2003) goes even further, pointingout that in many learned fields, science andpractice are often separate endeavors, andthat practice often has to precede science.Physicians were treating cancer long beforethey had much of an idea of what it wasand were using pharmaceutical agents likeaspirin long before the pharmacodynamicswere known. To quote Fox (2003):

The fact of the matter is that if

clinicians restrict themselves to

applying only narrowly validated

or known techniques, they will

never be of much value to society.

Lest you think that statement is an

invitation to charlatanism,

remember that clinicians do not

have the luxury to start from what is. They must start with theneeds of the people who come to them and then apply all the knowledge, information and skill they have to help resolve those problems.

On the other hand, we do have aproblem of accountability in health care,one that will surely affect psychology. Forexample, the current lag between thediscovery of more effective forms oftreatment in health care and theirincorporation into routine patient care ison the average 17 years. DeLeon (2003)predicts that health care in the 21st century,

abetted by technology, will be characterized

by even greater accountability for

practitioners, due to the combined effects

of the increasingly well-informed health

care consumer, who gathers relevant health

care information from the Internet; the

increasingly well-informed practitioner,

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who will be able to obtain best practiceinformation from a PDA; and increasedmonitoring of health care practices to flushout variation in treatment for specificdiagnoses. In this environment we aregoing to need betters ways to evaluatepractice. I would suggest that we considerusing the broad and inclusive definition ofevidence-based practice adopted by theInstitute of Medicine (2001). Thisdefinition consists of three components:best research evidence, clinical expertise,and patient values. This definition makesall components equal, provides a broadperspective that allows the integration ofthe research (including that on empiricallyvalidated treatments and that on

empirically supported therapy relation-

ships) with clinical expertise, and brings the

topic of patient values into the equation.

Such a model that equally values all three

components will better advance knowledge

related to best treatment and provide better

accountability.

As always, I welcome your thoughts on

this column. You can most easily contact

me via e-mail at [email protected].

ReferencesAmerican Psychological Association

Division of Clinical Psychology (1995).

Training in and dissemination of

empirically-validated psychological treat-

ments: Report and recommendations. TheClinical Psychologist, 48, 3-27.

Borkovec, T. D., Echemendia, R. J.,Ragusea, S. A., and Ruiz, M. (2001). ThePennsylvania Practice Research Network

and possibilities for clinically meaningful

and scientifically rigorous psychotherapyeffectiveness research. Clinical Psychology:Science and Practice, 8, 155-167.

DeLeon, P.H. (2003). Remembering

our fundamental societal mission. PublicService Psychology, 28, 8, 13.

Fox, R. E. (2003, August). Towardcreating a real profession of psychology. Paper

presented at the Annual Meeting of theAmerican Psychological Association,Toronto, Ontario, Canada.

Gonzales, J.J., Rngeisen, H. L., &Chambers, D. A. (2002). Clinical Psych-ology: Science and Practice, 9, 204-220.

Institute of Medicine (2001). Crossingthe Quality Chasm: A new Health Systemfor the 21st Century. (2001). Institute ofMedicine: Washington, DC.

Kendall, P. C. (1998). Empiricallysupported psychological therapies. Journal ofConsulting and Clinical Psychology, 66, 3-6.

Lambert, M. J., & Barley, D. E. (2001).Research summary on the therapeuticrelationship and psychotherapy outcome.Psychotherapy: Theory/Research/ Practice/Training, 38, 357-361.

Lilienfeld, S.O., Lohr, J. M., & Morier,D.(2001). The teaching of courses in the

science and pseudoscience of psychology:

Useful resources. Teaching of Psychology, 28,

182-191

Lohr, J. M., Fowler, K. A., & Lilienfeld,

S. O. (2002).The dissemination and

promotion of pseudoscience in clinical

psychology: The challenge to legitimate

clinical science. The Clinical Psychologist,55, 4-10

McFall, R. M. (1996). Manifesto for a

science of clinical psychology. The ClinicalPsychologist, 44, 75-88.

Meichenbaum, D. (2003, May).

Treating Individuals with Angry andAggressive Behaviors: A Life-Span CulturalPerspective. Paper presented at the Annual

Meeting of the Georgia Psychological

Association, Atlanta, GA. Norcross, J. C. (2001). Purposes,

processes, and products of the Task Force

on Empirically Supported TherapyRelationships. Psychotherapy: Theory/Research/ Practice/Training, 38, 345-356

Seligman, M.E.P. (1995). The

effectiveness of psychotherapy. AmericanPsychologist, 50, 965-974.

Seligman, M. E. P., & Levant, R.

(1998). Managed care policies rely on

inadequate science. Professional Psychology:Research and Practice, 29, 211-212.

Westen, D. and Morrison, K. ( 2001). A

multidimensional meta-analysis of

treatments for depression, panic, and

generalized anxiety disorder: An empiricalexamination of the status of empiricallysupported therapies. Journal of Consultingand Clinical Psychology, 60, 875-899.

Biographical SketchRonald F. Levant, EdD, ABPP, is a

fellow of Division 39 and a candidate forAPA President. He is in his second term asRecording Secretary of the AmericanPsychological Association. He was theChair of the APA Committee for theAdvancement of Professional Practice(CAPP) from 1993-95, a member at largeof the APA Board of Directors (1995-97),and APA Recording Secretary (1998-2000). He is Dean of the Center for

Psychological Studies, Nova Southeastern

University, Fort Lauderdale, FL.

Footnote1 Adapted from Levant, R. (in press).

The empirically validated treatments

movement: A practitioner/educator

perspective. Clinical Psychology: Science andPractice.

TEXASPSYCHOLOGICALASSOCIATION ANNUAL CONVENTIONSPONSORS

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Although each of these papers deals with

loss in some way, each one addresses a

different perspective and a different life

lesson. Dr. Davenport shares her thoughts

about anticipatory grief, drawing from her

experiences of losing her own mother. She

discusses what remains after the death of a

loved one and emphasizes the importance

of ritual and symbol. Dr. Nutt entertains us

by debunking the stereotype of the middle-

aged woman being over the hill. She

examines the research about the feminine

role and dwells on the positive aspects of

aging. Dr. Sharp discusses her work in grief

recovery. She presents a model of growing

through the grief process by looking at

spiritual, psychological, and sociological

issues. Dr. Vasquez describes theimportance of our mentors in ourprofessional growth. She examines how

their losses impact our thoughts about our

career goals and challenge us to look toourselves as mentors for those who canprofit from our experiences.

Part I: Midlife Loss of a Parent

For those of us who are lucky, ourparents did not die when we were youngand still quite dependent. Instead, we dealt

with their deaths when we were adults and

often after a significant period of caregivingand anticipatory grief during their decline.

Women typically carry the brunt of the

responsibility for caregiving of elderly

parents (Davenport, 1998). Accordingly,

they are often in more physical and

psychological contact with their parents in

the months or years preceding their deaths

than they had been heretofore, and the

ensuing sense of loss after death can be

especially acute. Further, as the Stone

Center’s Cultural/Relational theory

suggests, the connection between mother

and daughter can be especially close

(Jordan1997), which suggests that part of

the bereaved daughter’s identity may feel in

jeopardy as she attempts to come to terms

with what the loss means to her.

The Experience of LossThere is often a sense of generational

shift after a parent dies, especially after thedeath of the second parent (Donnelly,

2000; Myers 1997). Some authors (e.g.

Bartocci, 2000; Brooks, 1999; Levy, 2000)of popular books on loss of parentsadditionally suggest that it is inevitable for

the adult child survivor to feel like an

orphan; there is no longer any one to turnto for guidance, to share memories, or toserve as a buffer between herself and death.

The longest lasting familial bond has been

severed. Classical theories of bereavementwould support this contention, withdecathexis considered the goal of healthy

resolution of grief (Freud, 1917/1957).

Other writers (e.g., Davenport, 2002)

however, point out that while death ends

life, it does not end the relationship. For

many bereaved persons, the presence of the

deceased loved one may still be accessible.

Recent research (Francis, Kellaher, &

Lee, 1997; Klass & Walter, 2001; Rees,

1979) confirms that large numbers of

apparently healthy survivors report some

sense of ongoing connection with the

deceased. Sometimes this takes the form of

actually talking to the lost loved one. For

women, this is usually done in the home;

men often talk with their deceased fathers at

cemeteries. One study (Marwit & Klass,

1995) examined the function of the bond

that seems to transcend death and foundthat it was often maintained to providemoral guidance during difficult life

situations or to offer solace by claiming the

legacy imparted from the deceased.Sometimes the conversation is audible orwithin the bereaved person’s mind,

sometimes the parent’s memory is invoked,

and sometimes the past relationship is usedas a way to clarify values.

Another qualitative study of

psychologists (Davenport, et al., 2002)

indicated that a large majority of thoseinterviewed said that they also sometimesfelt the presence of their deceased parent—

sometimes through dreams, sometimes by

Challenging Issues for Women at Midlife

Donna Davenport, PhD; Roberta L. Nutt, PhD; Robbie N. Sharp, PhD; and Melba J.T. Vasquez, PhD

The following papers were written for a symposium sponsored by the Psychology of Women SpecialInterest Group at the Texas Psychological Association’s Annual Convention in 2002. The authors areall psychologists who have been involved in professional societies, academia, clinical practice, andfriendship, and who have shared the journey into midlife. We, as women and psychologists, wanted toaddress important issues at this point in our experiences, so that we might learn from our reflectionsand those of others.


doing an activity their parent used to do,and sometimes by deliberately invokingtheir memory. It seems clear that suchexperiences cannot be written off as asymptom of some psychopathology.

Spiritual/religious beliefs may be helpfulbut are not requisite for survivors to claimthis sense of ongoing connection. Forpsychologists who need psychologicalexplanations of the phenomenon,understanding it as accessing theinternalized love object works well (Baker,2001). Whether the continuingrelationship is conceptualized astranscendent or merely psychological, theexperience of it is often undeniable formany bereaved persons.

MemorialsSpecific activities or rituals are often

helpful for bereaved individuals (Combs &

Friedman, 1990) but perhaps especially so

for adult children who have lost their

parents. Creative expression, designed not

only to facilitate grief but also to honor the

deceased, can provide tangible memorials

that evoke the quality of the parent/child

relationship. One client of mine is

collecting all the pithy pieces of advice her

father was noted for dispensing and is

making a scrapbook for his grandchildren.

Another artist client painted a landscape

that her father was especially fond of and

said, “It’s like I’m shouting into the void—

See, I still love him! You can’t take him

away!” In writing the memoir after my own

mom’s death (Davenport, 2002), I found

that recollecting stories about her and about

her/our ancestors that she had told me overthe years provided an ongoing sense oflegacy we are both part of. During the

process, I wrote a poem in tribute to her

and our relationship. Now, four yearsalmost to the day since she died, it is whatseems to best capture my resolve to

maintain her importance in my life:

There is evil, I now know. I see it.Destruction that attacks you,

That deprives you of choice,That undermines your every effort.It feeds on our despair.My mother, it shall not win. This battle is not the last.So when you die,When it has taken you away—Piece by piece until finally gone—I will remember your love, your colors, The melody that is you.In some shining part of me,Your song will still be sung.More: Nothing can touch what

I prize the most.Far past these indignities,Past your death, past mine also,Through all the eons yet to come,I will always be your daughter.

Part II: Confronting CulturalStereotypes: Midlife as Liberation

As is true in many contexts, there has

been too much emphasis on the negatives

associated with midlife—particularly losses.

Losses are only one part of the story.

Media and Cultural AssumptionsOne of the biggest challenges of midlife

for women is confronting cultural

stereotypes routinely presented in media,

movies, television, magazines, etc. Middle-

age and older women are presented as sweet

little old ladies, hags, old bats, evil witches(ever see any evil old man costumes atHalloween? [Matlin, 1993]), and crones.

Aging is described as a scary process

generally leading to depression. Cultureassumes that aging is paired withincreasingly rigid ideas, loss of hearing, and

general ugliness—white hair, wrinkles, and

stooped posture.Advertising in the media spends millions

pushing cover-up makeup and a variety of

lotions and creams to fight the effects of

aging (Friedan, 1993). Even dishwashingdetergents claim to soften hands and makethem appear more youthful (Matlin, 1993).

Women are encouraged to seek cosmeticsurgery to change their natural looks and lieabout their age.

Double Standard of AgingMany experts on the aging process

describe a double standard of aging(Etaugh, 1993; Sontag, 1979). As men age,it is assumed that wrinkles give themcharacter and grey hair represents wisdom(Deutsch, Zolenski, & Clark, 1986). Withmaturity come increased competencies,respect, and financial security. Old men areseen as distinguished.

The opposite is typically true forwomen. As their appearance ages, they areless valued or even noticed (Bazzini,

McIntosh, Smith, Cook, & Harris, 1997;

Fodor & Franks, 1990). They do not gain

in perceptions of wisdom or distinction.

For women, aging is viewed as a

problem to be overcome, denied, or

avoided. Old women may be criticized for

using up resources and being a burden on

society and their families. Aging equals

deterioration, helplessness, frailty, and

confusion.

Culture assumes all elderly persons are

incompetent and living in nursing homes

(Friedan, 1993; Matlin, 1993). They are

isolated and hidden.

Well-Kept SecretIn reality, the advantages of midlife and

older for women are a well-kept secret.There is no denying the bodily changes and

increases in aches and pains and health risks

(Bee, 1996; Etaugh, 1993). However, thesechanges are well balanced by the positiveand dynamic increases in freedom and self-

definition. Women’s roles change, many

earlier obligations drop away, and womenhave a greater number of role choices andfeel less concern for the outside opinions

and criticisms of others. There was a recent

Oprah interview on television with SusanSarandon and Goldie Hawn, who had bothpassed 50. Both interviewees reported

feeling freer, sexier, and more joyous after

passing 50.


Psychological research has supportedthis positive view of aging for women fordecades. In today’s U.S. society, youngadulthood is often protracted, marriage isdelayed and overall health has improved(Matlin, 1993). The life span has grownlonger. Even the definition of midlife hasshifted upward. In 1900, the life expectancyfor women was less than 50; now it is closerto 80 (U.S. Bureau of the Census, 1993).The quality of life is also better, barringillness. Nutrition is better, people exercisemore, and new role possibilities haveincreased.

Contradicting Cultural AssumptionsResearch studies going back to the

1960s and 1970s (Hyde, Krajnik, &

Skuldt-Niederberger, 1991; Neugarten,

1968) found that women and men grow

closer together in personality characteristics

as they age. Women become more assertive

and independent, and men grow more

emotional, nurturing, and interpersonally

connected. A repeated midtown Manhattan

Longitudinal study assumed women’s

mental health deteriorates with age for

every decade after 20, but found drastic

improvement after 40. Later, the National

Center for Health Statistics found women

in their 40s, 50s, and 60s to be in as good

as or better mental health than women in

their 20s and 30s (Friedan, 1993). They

concluded there is more stress in the lives of

younger women.Few women have been shown to suffer

seriously with the stereotyped empty-nest

syndrome when children leave home (Bart,1971; Grambs, 1989; Rubin, 1979).Mitchell and Helson (1990) went so far as

to suggest that the early 50s are the prime

of life for women. Freed from parentingresponsibilities, women have new energy topursue other interests (Brown & Kerns,

1985). They demonstrate a joy in living

and liberation from monthly cycles, a highinterest in sex, an increased sense ofautonomy, and an ongoing interest in

friends, family, and careers (Jackson,

Chatters, & Taylor, 1993; Mitchell &Helson, 1990). Connectedness has been

shown to have a direct effect on positivemental health and mortality.

Research that has emphasized negativeaspects of aging has been criticized for usingthe institutionalized elderly while general-izing to the total population. These sampleswere convenient but did not representreality. It has also been suggested that thepersonal fear of aging in researchers mayhave caused bias in their research. Forexample, the assumed decline inintelligence for aging adults has been tied totest bias rather than any actual decline foractive individuals.

Suicide rates, another measure of mentalhealth, is significantly higher in males over65 (45.6 per 100,000) than women over 65

(7.5 per 100,000). Studies based upon

European-American, middle-class, edu-

cated women has shown them to be

independent, in charge of their lives,

adventurous, hard-headed, unconventional,

opinionated, individualistic, self-confident,

complex, and demonstrating high self-

esteem. They were reflective and

contemplative, demonstrated integrity, gave

high priority to instrumental functions,

were positive about menopause, and

welcomed new experiences. They were

interested in politics, social issues, and were

joyfully engaged in the present.

Career-oriented women at midlife

demonstrate more internal locus of control.

Women in leadership roles are confident,

sure of their own opinions, conscientious,

serious, assertive, determined, and creative.They value mentoring and empoweringothers.

Positive mental health of midlife and

older women is even more obvious incultures that revere older women (Grambs,1989). Many Native American tribes

valued wisdom in older women. Aboriginal

women in Australia are respected—theiradvice is sought on matters of importanceand they are involved in spiritual ritual and

community decision making. Among the

Kung people of southern Africa, statusincreases with age, as do spiritual powers.Older women can handle taboo and ritual

substances that are considered too powerful

for women still involved in bearing andcaring for children. Midlife is viewed as anew beginning.

It is time to change our culturalstereotypes. Midlife for women needs to beviewed in balance, describing both itsinherent changes and excitingopportunities.

Part III: Grieving and HelpingOthers To Do

One of the most gratifying and painfultasks I have encountered in professional lifewas finding a healthy way of addressing myown losses and helping patients andstudents to do the same. As a

developmental psychologist, I understand

and embrace the concept of change, letting

go of what was and making what is now a

part of my life. Too often we make these

transitions without allowing ourselves time

and energy to experience the feelings,

explore them, and say goodbye. In our busy

professional and personal lives, many of us

have adapted by rushing through this

process again and again. We lose so much

by not treating our losses as an important

component of our development — one that

teaches profound lessons.

What I found and continue to find in

the lives of others is how loss changes all the

relationships in our lives and how each of

these relationships must be examined and

renegotiated, at a time when emotions andexperiences are askew and structure seems

to be missing. Finding ways of grieving that

link the intellectual self with the emotionaland the spiritual self sustains us throughlosses by integrating the past with the

present. Across the past six years, my

colleague, the Reverend Dr. Peter Thomas,and I have developed our thinking abouthow to help persons grow through their

grief process. What began as a way to help

structure and organize those in our church-based grief recovery groups has evolved aswe have incorporated information from

participants and as we have discussed our

thoughts about grief as a developmentalprocess.


Our PhilosophyGrief occurs when persons experience

the loss of dreams, loved ones, jobs, homes,businesses, way of life, and health. Ratherthan passing through a series of stages thatcompartmentalize our emotional reactionsto these losses (e.g., Kuebler-Ross, 1969),we see people who are encompassed in anamalgam of spiritual, sociological, andpsychological changes that are interactive,in a constant state of flux, and commandattention. If these emotions, attitudes,behaviors, and thoughts can be structuredand organized within these dimensions(spiritual, sociological, and psychological),we find that healing can begin to take place.We see the loss as a crisis event, a life-

changing incident, and the crisis experience

as the amalgam of changes that are set in

motion by the crisis event.

Spiritual ProcessesUsing the twenty-third Psalms as a

metaphor for the experience of grief and

loss, Dr. Thomas describes a spiritualjourney from: 1) orientation — life that isgoing along in the expected manner, 2) to acrisis event, 3) to disorientation — the crisisexperience in the valley of the shadow ofdeath, and finally 4) to re-orientation —learning to incorporate the loss and to copein the new life. As an Episcopalian priest,Dr. Thomas is able to address many of thereligious belief systems that are shakenduring the crisis experience. He weaves thisinto the same developmental model ofchange, change experience, and integration(death, resurrection, and new life).

Psychological ProcessesUsing the familiar psychosexual stages

set out by Erik Erikson (1968), those who

are grieving can be reminded that they have

experienced this developmental sequence

time and again as they have progressed from

one stage of life to another. We have also

used this model to demonstrate how each

person has gained patterns of strength and

weakness as they have progressed throughthe process of growing and changing. Welook at a model of attachment, separation,and bereavement that allows participants toconsider how their families handled change,grief, and loss (Gerkin, 1989). We also haveformulated a model for presentingemotions of grief and loss and layers ofemotional responses that can get set upduring the grieving process.

Sociological ProcessesWe formulated a model that describes all

the relationships we believe personsexperiencing grief must negotiate orrenegotiate. This model sets out severalmajor areas of one’s self: spiritual (God,

worship, afterlife), family and friends,

institutions (legal, governmental),

vocation/avocation, and identity (roles,

work, play). Each relationship within those

categories is addressed during a crisis

experience. Some of these relationships are

greatly changed following the loss; some of

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these relationships are only slightlyimpacted. We believe that much of thework of grief is in reconciling one’s loss ineach of these relationships.

The WorkDr. Thomas and I find that discussing

ways of letting go, how old habits inhibitnew habits, the use and importance ofrituals, ways to acknowledge the reality ofthe past, and a format to plan for the futureand evaluate the present helps orient thosein grief. We have structured our GriefRecovery Course to be a psychoeducationalgroup rather than a therapy group. Webelieve that the group setting and groupprocess is an integral part of the healing

process, although we emphasize that each

person experiences grief in his or her own

way and at his or her own pace.

The midlife challenge for me has been to

find a means of coping with inevitable

losses and changes. By incorporating

written materials, conducting groups,

encountering examples in my clinical work,

and formulating my ideas and perspectives

on how I see loss, change, and coping, a

framework has evolved that allows me to

help structure and organize the

overwhelming experience of grief. As we

complete our book, both Dr. Thomas and I

have found ways of communicating these

ideas to others, thus allowing them to grow

through their own grieving.

Part IV: Mentoring at Midlife:Losses, Gains andChallenges

One of the most important difficulties

faced by women graduate students andyoung professionals has to do with

obtaining mentors. Worell and Johnson(1997) describe the reasons as the lack of

female faculty, and the tendency for malefaculty to have less identification and

contact with female students than they dowith male students. Women of color have

even less access to informal contact with

advisors, especially with mentors who arefamiliar with ethnic as well as gender issues.Often, women, and women of color, obtain“situational mentoring” from varioussources and persons. I am one of many whohas obtained rich and diverse mentoringfrom a number of sources, including fromsome of the few women of colorpsychologists who came before me. I amnow at the age, chronologically andprofessionally, when those mentors areretiring or dying. At midlife, one of thedevelopmental issues is the loss of mentorsthrough retirement, disability and/or death.The loss of a couple of my mentors has hada major impact, and I’d like to share theexperience of one of those losses.

Dr. Martha Bernal contributed

significantly to the advancement of ethnic

minority psychology. She unfortunately

suffered from three different bouts of

cancer, including the final one that took her

life prematurely on September 28, 2001 in

Black Canyon City, Arizona.

Martha was the first Latina in the

United States of America to receive a PhD

in Psychology; she received it at Indiana

University at Bloomington. The focus of

her research during the first part of her

career was on parent-training approaches

for behaviorally deviant children. For the

last 20 years of her career, her research

focused on the ethnic identity of Mexican

American children. Dr. Bernal published

about 60 articles and book chapters, several

books, was guest editor of journals, andpresented numerous papers. In the early1970s, she dedicated herself to the goal of

ensuring that more Latinas and Latinos had

the opportunity to receive graduatetraining. She applied much of her researchto increase the status of ethnic minority

recruitment, retention and training. Her

social action research was designed to focusattention on the dearth of Latino/apsychologists and to recommend steps for

addressing that problem. She published

seminal articles in the American Psychologist(Bernal and Castro, 1994; Bernal & Padilla,1982) and The Counseling Psychologist

(Quintana & Bernal, 1995) thatdocumented the dearth of minoritygraduate students and faculty members inpsychology departments throughout theUnited States. James Jones, anothermentor, said:

I have known Martha since the mid-1970s. She has always been a focused advocate for people of color in psychology, and for Latinas in particular. She was a leader at the Dulles Conference that established the foundation for so many of the ethnic/racial minority programs, organizations we are involved in today. She was always tough-minded, but equally tender-hearted. She was

creative as a scientist, administrator,

teacher and advocate, and

compassionate as a friend and

colleague. Martha was a giant in our

field, a first among many, and a

gift to us all. I was privileged to

count her as a friend, and I will

miss her.

When I first met Dr. Bernal at a

California symposium on Chicano

psychology, I was a graduate student. My

peers and I were enthralled to see her—we

could not believe that she was only five feet

tall! Yet, she stood very tall to many of us.

She was such an important symbol of

success, achievement, persistence, and

spunkiness. She could push and challenge

us. She could be tender, gentle and

supportive. She was a treasure.People assumed that I was one of her

students. I never was. She was willing to be

a “situational mentor” at times, serving as

Chair of Symposia at APA, and otherwiseproviding consultation for variousprofessional situations. She directly and

indirectly provided guidance and

inspiration to a wide range and number ofpsychologists of color, men and women.Those who knew her perceived her as an

exceptional and phenomenal woman. She

blazed a trail that allowed many of us to behere.

I realize with relief that I had a couple of


opportunities to honor Dr. Bernal beforeshe died. Steve Lopez and I organized hernomination for a major APA award the yearbefore she died, and she was awarded thehonor! That is partly the reason that he andI worked together to publish her obituaryin the American Psychologist; we had thematerial and the emotional motivation. Inaddition, the National Latino PsychologyConference held in San Antonio in 2000was in her honor, and as a keynote speaker,I focused much of the talk on her and herwork (Vasquez, 2000). All of this wasbefore we knew she was ill. At APA inChicago 2002, my talk for an award whichI received was also in her honor (Vasquez,2002). A version of that talk is published in

the American Psychologist. This realization

leads me to underscore what we know:

demonstrating care before and after the

death of someone helps the grief process.

She knew we cared about and honored her.

In 1999, the first National Multicultural

Conference and Summit was held in

Newport Beach, California. Four

psychologists of color, including myself,

devoted our APA divisional presidential

year to cohosting this conference. One of

my projects was a panel, “Honoring Senior

Women of Color.” Reiko True, Carolyn

Payton, Martha Bernal, and Carolyn

Attneave (posthumously) were honored and

asked to speak about their experiences with

racism and sexism (Sue, Bingham, Porche-

Burke & Vasquez, 1999). It was a powerful,

funny, poignant and unforgettable event!Three of the four pioneer women of colorhonored at the first National Multicultural

Conference and Summit in 1998 have now

died, meaning that the numerousprofessionals whom they mentored haveexperienced a significant loss of mentors.

Consequently, women of color who are

developmentally, professionally andchronologically at midlife may be findingthemselves the “senior” mentors available to

graduate students and young professionals.

This position can be terrifying as well as anhonor. Most of us do not feel ready to be inthe role in which we find ourselves.

Developmental models describe transitionperiods as both a challenge and anopportunity. Challenges include theexpectations and requests from varioussources, which can be overwhelming. Stressmanagement models seem inadequatewhen I find myself with requests from somany graduate students and youngprofessionals. Even those of us not inacademia get called upon to review thecredentials of young multiculturalprofessionals up for tenure, to beinterviewed by students for a class onmulticulturalism, to give talks atuniversities for programs attempting toprovide multicultural psychologists rolemodels, etc. Setting boundaries and

providing referrals to colleagues are of

course important strategies, but every time

I do so, I am aware of the missed

opportunity to provide someone with the

experiences that I so treasured from others.

Yet the opportunity to give in these ways

also provides meaning to my professional

life and allows me to experience the basic

need to make contributions and to be

productive.

According to Gelso and Lent (2000) in

their chapter on research in the Handbookon Counseling Psychology, research on

mentoring relationships underscores the

major importance of this relationship in the

professional’s life. Professionals who

recollect their graduate school experience

comment on the centrality of the

relationships and the negative impact oflack of mentoring. Despite the research thatis out there, there is now no formal theory

of the mentoring relationship, although

informal observations such as mine exist.This is an area of inquiry in its early stages.However, I hope that theory development

includes the aspects of the transition from

student to mentor, and the losses, gains andchallenges involved in that process.

ConclusionThe challenges at midlife include

various kinds of losses, the literal loss ofparents and mentors, changes in roles, and

increased risk of health and bodily achesand pains! Loss changes every relationshipin our lives. Each of these relationships andtheir impact must be examined andrenegotiated at a time when emotions andexperiences are askew and structure seemsto be missing. These challenges, however,are also opportunities for life-enhancingtransformation. Indeed, the pain of lossmay be conceptualized as simply a part ofthe process of developmental trans-formation. Midlife is a time when we are allstruggling with losses, but these changes arewell balanced by the positive and dynamicincreases in freedom and self-definition.This paper identifies ways to transform andbenefit from the challenges of loss, and

enjoy the opportunity for increased

contribution, productivity, and a sense of

well-being. Our profession as well as our

society must that emphasize and appreciate

this perspective.

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Bee, H. (1996). The journey ofadulthood. Upper Saddle River, NJ: PrenticeHall.

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✯


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Combs, G. & Friedman, J. (1999).Symbol, story, & ceremony. NY: Norton.

Davenport, D.S. (2002). Singing motherhome: A psychologist’s journey throughanticipatory grief. Denton: UNT Press.

Davenport, D.S. (1999). Dynamics andtreatment of middle-generation women. InM. Duffy, Ed. Handbook of counseling andpsychotherapy with older adults. NY: JohnWiley.

Denmark & M. A. Paludi (Eds.),Psychology of women: A handbook of issuesand theories. Westport, CT: Greenwood

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Deutsch, F. M., Zalenski, C. M., &

Clark, M. E. (1986). Is there a double

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Donnelly, K (2000). Recovering from

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Erikson, Erik. (1968). Identity: Youthand Crisis. New York: W. W. Norton & Co.

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Vasquez, M. J. T. (2000, November).

The Amazing Challenges and

Achievements of Latino Psychologists: A

Tribute to Martha Bernal, PhD Invited

Keynote Address presented at the

Conference, Latino Psychology 2000:

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Vasquez, M. J. T. (2002). Complexities

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American Psychological Association. Pp 1-

14.


Ramona Aarsvold PhD Marcia Abbott PhD Marianna Adler PhD Joan Anderson PhD

Carolyn Anderson PhD Judith Norwood Andrews PhDLarry Aniol PhD Richard Austin, Jr. PhD Laurie Baldwin PhD Eileen Barbella PhD Elizabeth Barry PhD Patricia Barth PhD Deborah Barton PhD Julie Bates PhD James L. Baxter MA Karen Belter PhD Robert Blake PhD Bonnie Blankmeyer PhD Deborah Boelter PhD Hautina Bollinger PhD Rosie Bostick PhD Joy Breckenridge PhD Bonnie Brookshire PhD Stacy Broun PhD J. Martin Brown PhD Timothy Brown PhD Joan Bruchas PhD Erica Burden PhD Robin Burks PhD Roger Burns PhD Mary Burnside PhD Sam Buser PhD Kay Campbell PsyD Bob L. Carpenter Ralph Casazza PhD Joseph M. Casciani

Mercy Chieza PsyD Gloria Chriss PhD Antoinette R. Cicerello PhDPauline Clansy EdD Donna Copeland PhD Carol Cossum EdD Ray Coxe PhD Harold Crasilneck PhD Rosalie Cripps PhD Maria Concepcion Cruz PhDWalter Cubberly PhD Jack Deines PhD Anitra DeMoss PhD Alexandria H. Doyle PhDPatricia Driskill PhD Michael Duffy PhD, ABPPMelody A. Dunbar MS Dianne Dunn PsyD Ann L. Dunnewold PhD

Richard E. Eckert PhD Anette T. Edens PhD Richard R. Eiles PhD Virginia (Ginger) Enrico PhDRichard Ermalinski PhD Robert Federman EdD

Stephen E. Finn PhD Alan T. Fisher PhD Joseph E. Fogle PhD Duncan L. Forest PhD Edward Framer PhD Eric Frey PhD Lois C. Friedman PhD Shirley Friedman EdD Lois C. Friedman PhD Cheryl Fuller PhD Marsha T. Gabriel PhD Ronald Garber PhD Lauren M. Gaspar Michael Gaubatz Michael R. Ghormley BS Martin Gieda PhD Penny M. Goffman PhD Rolf W. Gordhamer PhD Addison Gradel EdD Melissa Graham MEd

Dennis Grill PhD Pamela B. Grossman PhD Carol A. Grothues PhD Gerald (Jerry) Grubbs EdD, MSCP William B. Gumm PhD Ranee B. Gumm PhD Michele Guzmßn PhD Cheryl L. Hall PhD Lester E. Harrell PhD Michelle T. Hart PhD Sophia K. Havasy PhD Marian H. Higgins PhD Robin Hilsabeck PhD Clifford L. Hirsch PhD Tamara Hodges C. Alan Hopewell PhD David Hopkinson PhD Melanie L. Horn PhD Sandra L. Hotz PhD Donna Hughes PhD Cheryl F. Hughes PhD Mary A. Gordon Hurd PhD Adele H. Hurst PhD C. Robert Ingram Daniel W. Jackson PhD Linda J. Jackson PhD A. Jack Jernigan PhD Thomas Johnson A. Michael Johnson PhD

William Jones PhD Krista D. Jordan PhD Frances H. Kimbrough PhDBurton A. Kittay PhD Christopher L. Klaas PhD Joseph C. Kobos PhD Kenneth Kopel PhD Bruce Kruger PhD Richard P. Krummel PhD Tom Kubiszyn PhD Angela Ladogana PhD John W. Largen PhD Sarah Lederer Snow Mark Lehman PhD Bert D. Levine PhD Franklin D. Lewis PhD Mary A. Little PhD David S. Litton PhD

Daniel L. Logan PhD Dwayne D. Marrott PhD Xavier Martinez PhD Lynn M. Matherne PhD Patricia McBride-Houtz PhDJames C. McCabe PhD Donald C. McCann PhD David G. McCarley PhD Joyzelle H. McCreary PhD

Robert F. Mehl PhD Muriel Meicler PhD Maritza Milan PhD Robert W. Moats PhD William Montgomery PhD Leon Morris EdD Gary Neal PhD Naomi D. Nelson PhD Walter Newsom PhD Norma Ngo PsyD Christopher G. NikolaidisMargaret P. Norris PhD Gina R. Novellino PhD Roberta L. Nutt PhD Frank D. Ohler PhD George Parker PhD Carole G. Pentony PhD Harold Perry PhD P. Caren Phelan PhD Kim Praderas PhD John Price PhD

Lynn Aikin Price PhD Jayne M. Raquepaw PhD Karen Rasile PhD John K. Reid PhD Herbert Reynolds PhD Elizabeth L. Richeson PhD Dan Roberts PhD

Richard Rogers PhD Olga Ruiz de Arana EdD Earl S. Saltzman PhD Barbara Sanford PhD Gordon C. Sauer, Jr. PhD John Savell PhD Lawrence Schneider PhD R. Gaston Scott EdD John Sell PhD Cristina Serrano PhD Verlis L. Setne PhD Theresa Sharpe PhD Huntly Shelton PhD Jeffrey C. Siegel PhD Tana Slay PhD W. Truett Smith PhD Nanette Stephens PhD Jana Swart PhD Arthur R. Tarbox PhD Daniel J. Thompson PhD Thomas J. Tully EdD Dana B. Turnbull M.A. Thomas A. Van Hoose PhD Nancy D. Van Morkhoven Dr PHJessica Varnado PhD Melba J. T. Vasquez PhD Laurel Bass Wagner PhD Belinda Walker PhD Michael Walker EdD David J. Welsh PhD Joan Weltzien EdD

Peggy Wheaton PhD Thomas L. Whiddon MS Jim C. Whitley EdD Christina Williams PhD Alison Wilson PhD Nancy E. Wilson PhD James R. Womack PhD Murray E. Worsham PhD Mimi Wright PhD Jarvis A. Wright, Jr. PhD

Sara Young PsyD Robert Zachary PhD Carol Zuccone EdD Burton J. Zung PhD

Sunrise Fund Contributors


Doctoral MembersSheryl Gordon Beatty, PhDJoan Biever, PhDKier Bison, PhDWilliam Brown, PhDLyle Cadenhead, PhDMimi Cotellesse, PhDMary Damkroger, PhDJosephine De Los Santos, PhDSid Dickson, PhDMarie-Elise DuBuisson, PhDPhilip Dunbar, PhDKelly Goodness, PhDHenry Hanna, PhDMargaret Jordan, PhDJon Lasser, PhDLisa Lind, PhDAlice Lottes, PhD

Gloria Miller, PsyDMonte Miller, PsyDFrankie Paulson-Lee, PhDJoellen Peters, PhDAdam Saenz, PhDCharles Scherzer, PhDTheresa Sharpe, PhDSonia Simon, PsyDGregroy Simonsen, PhDVictoria Sloan, PhD

Associate MembersManuel Dominguez, MADana Truman-Schram, MAStephanie Tong, MA

StudentsDaniel Altman, MS

Trisha Bement, MSCatherine Callender, MS, MEdLisa Cepeda, BARachel ChaunceyMelissa Graham, MEdMelenie Hohensee, MEdWilliam Jarrold, MAMarie Lamothe-Francois, BAJulie Maggard, BAIvana RadovancevicNora Resendez, BAJack Tsan, BASusana Verdinelli, MEdAlicia Valle, BSKenneth Whitton, Jr.Mickie Wong

New MembersThe following individuals joined TPA between June 26, 2003 and August 20, 2003.

TPA welcomes all of our new members.

PSY-PAC UPDATE

J. Paul Burney, PhD

I want to personally thank all TPAmembers who have contributed to PSY-PACthis year, our PSY-PAC Board of Directors,and Dr. Ron Cohorn, PSY-PAC PastPresident, for his advice, insight, andwisdom.

PSY-PAC had an excellent year in spite ofthe Texas and national economy. FromJanuary to August of 2002, 95 PSY-PACmembers donated $29,085.29, including

funds for RxP. During the same period this

year; 204 PSY-PAC members contributed

$35,583.13, including RxP. This represents

a 22 percent increase of $6,497.84 in

donations and a 115 percent increase of 109

additional members. In January throughAugust of 2002, we received 12 donations of$1000, one donation of $2000, and onedonation of $4000. For the same timeperiod this year, we also received sixdonations of $1000.

The year 2004 will be an important yearfor TPA and PSY-PAC as we beginpreparation for the 2005 Sunset Review ofour Psychology License and Practice Act.

We will need to be present at legislative

events, fundraisers, and receptions to

educate our legislators about the importance

of psychology as a profession and the

benefits we provide to society.

TPA’s legislative success requires effectivegrassroots activism, personal contact withlegislators, solid lobbying, and generousfinancial contributions. If you are notcurrently a member of PSY-PAC, take theopportunity to join and contribute at TPA’sAnnual Convention in Dallas on November6-8. PSY-PAC’s Annual Board Meeting willbe 8 a.m. - 9 a.m., Saturday, November 8and all members are encouraged to attend.

All members who have contributed $100 or

more are eligible to vote on all PSY-PAC

matters. Thank you for your current and

continued support and for making this a

very successful PSY-PAC year.


$2000

Edward Davidson, PhD

$1,000 - $1,999

Walter Bordages, PhD

Tim Branaman, PhD

Paul Burney, PhD

Cheryl Hall, PhD

Ethel Hetrick, PhD

Alan Hopewell, PhD

Kenneth Huff, PhD

James Quinn, PhD

Deanna Yates, PhD

$500 - $999

Frankie Clark, PhD.

Richard Fulbright, PhD

Morton Katz, PhD

Lane Ogden, PhD

Dean Paret, PhD

Mimi Wright, PhD

$100 - $499

Barbara Abrams, EdD

Laurence Abrams, PhD

Joan Anderson, PhD

Kyle Babick, PhD

Elizabeth Barry, PhD

Patricia Barth, PhD

Barbara Beckham, PhD

Connie Benfield, PhD, ABPP

Joan Berger, PhD

Lee Berryman-Tedman, PhD

Malcom Bonnheim, PhD

Peggy Bradley, PhD

Ray Brown, PhD

Bradford Brunson, PhD

Erica Burden, PhD

Robin Burks, PhD

Lyle Cadenhead, PhD

Linda Calvert, PhD

Elaine Calaway, PhD

Paul Chafetz, PhD

Gloria Chriss, PhD

Pauline Clansy, EdD

Karen Claridge, PhD

Ron Cohorn, PhD

Maria Concepcion Cruz, PhD

Sean Connolly, PhD

Raye Coxe, PhD

Jim Cox, PhD

Robert Cross, PhD

Walter Cubberly, PhD

Caryl Dalton, PhD

Patricia Driskill, PhD

Michael Duffy, PhD, ABPP

Annette Edens, PhD

Wayne Ehrisman, PhD

Raymon Finn, PhD

Alan Fisher, PhD

Joseph Fogle, PhD

Ann Friedman, PhD

Michael Gottlieb, PhD

Steven Gray, PhD

Susan Gifford, PhD

Jerry Grammer, PhD

Chuck Gray, PhD

Josue Gonzalez, PhD

T. Walter Harrell, PhD

Charles Haskovec, PhD

Sophia Havasy, PhD

Swen Helge, PhD

Scott Hickey, PhD

David Hopkinson, PhD

Robert Hughes, PhD

Sheila Jenkins, PhD

Kevin Jones, PhD

Charles Keller, PhD

Burton Kittay, PhD

Christopher Klaas, PhD

Harry Klinefelter, III, PhD

Kenneth Kopel, PhD

Angela Ladogana, PhD

Mark Lehman, PhD

Nancy Leslie, PhD

Alaire Lowry, PhD

Tom Lowry, PhD

Janna Magee, PhD

Patricia Martinez, EdD

Xavier Martinez, PhD

Donald McCann, PhD

Glen McClure, PhD

Joseph McCoy, PhD

Jerry McGill, PhD

Richard McGraw, PhD

Robert McKenzie, PhD

Robert McLaughlin, PhD

Robert Mehl, PhD

Muriel Meicler, PhD

James Meredith, PhD

Brad Michael, PhD

Charles Middleton, PhD

Robert Mims, PhD

Lee Morrisson, PhD

Leon Morris, EdD

Suzanne-Mouton-Odom, PhD

Joanne Murphey, PhD

Frank Ohler, PhD

Michael Pelfrey, PhD

Laurence Perotti, PhD

Sally Porter, EdD

Shelly Probber, PsyD

Walter Quijano, PhD

Lynn Rehm, PhD

John Reid, PhD

Elizabeth Richeson, PhD

Laurie Robinson, PsyD

Leigh Scott, PhD

Robbie Sharp, PhD

Jev Sikes, PhD

Laura Spiller, PhD

Nannete Stephens, PhD

Alan Stephenson, PhD

Thomas Van Hoose, PhD

Mark Voeller, PhD

David Wachtel, PhD

Michael Walker, PhD

David Welsh, PhD

Joan Weltzien, EdD

Richard Wheatley, PhD

Michael Whitley, PhD

M. Wright Williams, PhD

Shirely Willis, PhD

Connie Wilson, PhD

James Womack, PhD

Eirene Wong-Liang, PhD

Kathryn Wortz, PhD

John Worsham, PhD

Jarvis Wright, PhD

Under $100

Elizabeth Abbott, PhD

Lynn Aiken Price, PhD

Bruce Allen, PhD

Martin Ancona

Carolyn Anderson, PhD

Karen Belter, PhD

Karen Berkowitz, PhD

Ronald Boney, PhD

Bonnie Brookshire, PhD

Stacy Broun, PhD

Timothy Brown, PhD

Amos Bruce, PhD

Sam Buser, PhD

L.Carol Butler, PsyD

Jane Carr, MA

Ralph Casazza, PhD

Terri Chadwick, PhD

C. Munro Cullum, PhD

Kenneth Cyr, PhD

Dana Davies, PhD

Sally Davis, PhD

Sharon Davis, PhD

John Deines, PhD

Alfred Dooley, EdD

Alexandria Doyle, PhD

Jean Ehrenberg, PhD

William Erwin, PhD

George Faibish, PhD

Elizabeth Fowler, EdD

Alan Frol, PhD

Adrienne (Ann) Gardner, PhD

Sylvia Gearing, PhD

Jayne Gordon, PhD

Lois Graham, PhD

Pamela Grossman, PhD

Carol Grothues, PhD

Barbara Hall, PhD

Jo Beth Hawkins, PhD

Annette Helmcamp, PhD

David Hensley, PhD

Victor Hirsch, PhD

Carola Hundrich-Souris, PhD

Adele Hurst, PhD

Sarah Kramer, PhD

Richard Krummell, PhD

Wanda Kuehr, PsyD

Betty Lanier, EdD

Rebecca LeBlanc, PhD

Rochelle Levit, PhD

Stephen Loughhead, PhD

Marilyn Maas, PhD

Patricia Mahlstedt, EdD

Dwayne Marrot, PhD

Charles McDonald, PhD

Stuart Nathan, PhD

Dorothy Pettigrew, PsyD

Aurelio Prifitera, PhD

Janet Rexroad, EdD

Harriet T. Schultz, PhD

Norman Shulman, EdD

Gregory Simonsen, PhD

Jana Swart, PhD

Thomas Tully, EdD

Patricia Weger, PhD

Mark Wernick, PhD

Deborah Gleaves, PhD

Alison Wilson, PhD

2003 PSY-PAC ContributorsApril 1, 2003 – June 25, 2003

32 Texas Psychologist

WINTER 2003

@Does TPA have your e-mail address?If not, you could be missing out on

important announcements about

upcoming CE opportunities and

numerous other important updates.

If you have not been receiving

announcements from us via e-mail,

then we don’t have your current

address. To have your e-mail address

added, send your updated address to

[email protected].

E-mail Updates

Training Workshops

Contact the Special EducationAssessment Specialist at your Regional

Service Center to register or for more information.

A workshop fee may be charged at some centers.

ESC Region 1 Edinburg 10-Nov 11-NovESC Region 2 Corpus Christi 18-NovESC Region 3 Victoria 4-Sep 1-OctESC Region 4 Houston 9-Dec 15-Jan 4-Mar 3-JunESC Region 5 Silsbee 10-DecESC Region 6 Huntsville 23-OctESC Region 7 Kilgore 30-OctESC Region 8 Mt. Pleasant 5-DecESC Region 9 Wichita Falls 2-DecESC Region 10 Richardson 25-Sep 26-Sep 3-Nov 4-NovESC Region 11 Fort Worth 23-Sep 28-OctESC Region 12 Waco 20-OctESC Region 13 Austin 17-Sep 17-Oct 27-OctESC Region 14 Abilene 21-OctESC Region 15 San Angelo 15-SepESC Region 16 Amarillo 21-AugESC Region 17 Lubbock 8-SepESC Region 20 San Antonio 30-Sep 14-Oct

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