In This Issue: Katherine Nordal and James Brayc.ymcdn.com/sites/ Tom Dimperio, PhD and Rhonda ......

In This Issue:In This Issue:In This Issue: Fall 2011

NMPA President Ken Gilman’s Column see page 3 NMPA Fall Conference October 14 Albuquerque see pages 4 & 5 Fall 2011 Friday Forums Register today! see pages 6 & 7 SIAP/NMPA November 12 Las Cruces Workshop with Katherine Nordal see page 8 Message from NMPA’s Early Career Psychologist see page 9 Frank Spring’s Book Review: ―The Emperor’s New Drugs” see Pages 10 & 11 NMPA’s New Members see page 14

Katherine Nordal and James Bray Scheduled for 2011 Fall Workshops

Nordal to Headline Las Cruces Workshop

Registration is open for the 2011 NMPA Fall Conference, Psy-chological Practice in Primary Care: An Integrated Model, on Friday, October 14, at the Indian Pueblo Cultural Center, 2401 12th Street NW, Albuquerque (see pages 4 and 5 for de-tails). NMPA President Elect Tony Kreuch said this year’s con-ference explores the emerging role of the psychologist in health care settings and in particular in the integration of psychological practice within the primary heath care environment. The confer-ence offers a total of 9.5 continuing education credits (6.5 work-shop and 3 online credit hours).

The conference fee includes a New Mexican luncheon with vegetarian options and three home-study cultural diversity or ethics continuing education credit hours from NMPA’s Cultural Compe-tence/Ethics web page at www.nmpa.com. You can also register online for our upcoming Albuquerque and Santa Fe Friday Forums and for the Las Cruces workshop. Albuquerque Friday Forums will be held from 1-5 PM. Fridays, Kaplan Class-rooms, 8205 Spain NE, details on page 6 and 7. The Santa Fe Friday Forum will be held at the Medical Dental Building, 465 St. Michael’s Drive, Santa Fe. Albuquerque September 30 - ―Neuropsychological and Neuroimaging Correlates and Current Con-ceptualizations of ADHD and Bipolar Disorder in Children" presented by Rick Campbell, PhD, An-drea Sherwood, PhD, and John King, PhD of UNM Department of Psychiatry, Center for Neuropsy-chological Services.

Albuquerque October 7 - "Fetal Alcohol Spectrum Disorders: Diagnosis, Neurocognitive Profile and Interventions" presented by P.W. Kodituwakku, PhD and Louise Kodituwakku, PhD

Albuquerque October 28 or Santa Fe November 4 - ―Aging: Navigating the Final Frontier‖ presented by Tom Dimperio, PhD and Rhonda Dimperio, RN

NMPA does not accept funding, services, donations, donations in kind, or sponsorships from pharmaceutical companies

APA’s Executive Director for Professional Practice Katherine C. Nordal, PhD will be the keynote speaker for a three-hour workshop, ―Broadening Our Reach: Psychologists’ Roles in the Next Dec-ade,” sponsored by NMPA and the Southwest Institute for the Ad-vancement of Psychotherapy (SIAP) in Las Cruces, NM, on November 12, 2011. Dr Nordal will give us an insider’s view of the major changes in the practice of psychology that are already occurring as a result of health care reform. There are only 30 seats available for this conference. Please call NMPA at 505-883-7376 or go online at www.nmpa.com if you wish to attend. We expect seats to fill up within a few weeks.

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2011 NMPA Leadership

President Ken Gilman, PhD [email protected]

President Elect Tony Kreuch, PsyD [email protected] Past President Rex Swanda, PhD

[email protected]

Treasurer Susan Cave, PhD [email protected]

Secretary Jan Griffin, PhD

[email protected] Continuing Education Review Debra Saslawsky, PhD [email protected]

BOPN Representative Bobby Holstead, PhD [email protected] Legislative Chair Dan Matthews, PhD BoPE Liasion [email protected]

Membership Committee Chair Susan Cave, PhD Nominations Chair Tom Sims, PhD

[email protected] Distance Learning Chair Ken Gilman, PhD Friday Forum Chair JoAn Rittenhouse, PhD

[email protected] APA Council Representative Michael Rodriquez, PhD

[email protected]

APA Public Education Coordinator Rex Swanda, PhD

[email protected]

APA Diversity Delegate Ricardo Gonzales, PhD

[email protected]

APA Disaster Response Robert Tanner, PhD

[email protected]

Rural Health Coordinator Elaine LeVine, PhD

[email protected] Early Career Psychologist Nicole Duranceaux, PhD

[email protected]

APA Federal Advocacy Deborah Okon, PhD

[email protected] Division of Psychopharmacology Chapter II Northern New Mexico Chair Chapter III Southern New Mexico Chair Members at Large: Bradford C. Richards, PhD [email protected]

Rigena Nordyke, PhD [email protected] Cheri Koinis, PhD [email protected] Cathy Simutis, PhD [email protected] Susan Zorn, PhD [email protected] 2011 Ethics Committee:

Rex Swanda, PhD [email protected]

Emily Driver Moore, PhD [email protected] Elizabeth Penland, PhD [email protected] Monica Gilboa, PhD [email protected]

Executive Director NMPA Amelia Myer 8205 Spain NE, Suite 202 Albuquerque, NM 87109

[email protected] 505-883-7376

Lobbyist 301 Edith Blvd NE Peter Mallory, JD Albuquerque 87102 [email protected] 505-243-9529

The New Mexico Psychologist

is a publication of NMPA. Opinions and articles are

welcome. Any article is subject to editing. Please send articles and letters to [email protected]

Newsletter Editor: Julie Lockwood

[email protected]

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The New Mexico Psychological Association

President’sPresident’sPresident’s COLUMN By Ken Gilman, PhD

When I was in graduate school (before books were available electronically, when google was just a whimsically named very big number and the spirit du-plicator was cutting edge technology), I remember reading an article about psychology as a conservative/reactionary profession, serving the status quo. The reference is long lost, but the gist was that a role of discomfort is to cre-ate incentive to change. And that in helping our clients feel better, we may vent the pressure whence comes inspiration to change (whether through con-structive adaptation or acting out). Threads from that article pop into my head, unbidden, from time to time. I have not seen the empirical studies yet, but my own anecdotal stuff assures me that more change is happening faster all the time. Our profession seemed so much simpler back when I started. At the APA State Leadership Conference the past two years, the theme has been anticipating change and trying to keep up with, if not staying ahead of the curve. Sometimes that change looks like great opportunity, at other times, like an ominous threat. Our training has provided us with an incredible array of skills when it comes to assessing and working on problems, sets of methods, skills and perspectives and some facility in communicating all of that to consumers of one kind and another. So whether it's finding a place in the alphabet soup of programs that Ricardo Gonzales so helpfully de-scribes within the newly developing health care delivery system or other niches in legal, management or systems problem solving arenas, opportunities for creative problem solvers abound. Or for some of us, there's always the lure of using those professional caliber coping skills we've acquired to just hang in there until those 401(k)s and Social Security kick in so we can live happily ever after. Up whichever stream your boat is headed, NMPA remains a great resource of creative, helpful folk to aid the journey.

Ken Gilman

Albuquerque area NMPA group meets at the Range Café in Bernalillo, from left, Carolina Yahne, Cathy Simutis, Laura Smith, Chuck Elliott, Mike Baron, Hilary Hale and Liz Penland.

Register Online at www.nmpa.com

NMPA 2011 Fall Conference: Psychological Practice in

Primary Care: An Integrated Model Friday, October 14, 2011

Indian Pueblo Cultural Center 2401 12th Street, NW, Albuquerque, NM

9.5 CE credits (6.5 workshop and 3 online) for psychologists, social workers and counselors

3 Category I cultural diversity hours plus 3 Category II online cultural diversity/ethics hours included

WORKSHOP DESCRIPTION: The general focus of this year’s conference is on the emerging role of the psychologist in health care settings and in particular the inte-gration of psychological practice within the primary health care envi-ronment. Psychologists are increasingly called upon to provide a variety of services including consultation, assessment and interven-tion within primary care settings and to fully participate as members of multidisciplinary health care teams. Central questions for the conference include: What are the challenges that psychologists face as they move into this newly emerging professional practice role? What new and/or specialized skills do psychologists need to learn in order to effectively make this transition? How can New Mexico psychologists more effectively address the unique diversity and rural needs in collaboration with primary care in our state?

This workshop is approved for a total of 9.5 credit hours of continu-ing education for New Mexico psychologists, social workers and counselors. 6.5 credits are Category 1 workshop credits (of which three hours have cultural diversity content), and an additional three credits are Category 2 distance learning credits (all of which are your choice of either cultural diversity or ethics hours) and will be earned by completing online cultural diversity or ethics coursework at www.nmpa.com. Your fees include morning coffee, tea, and Danish, a New Mexican buffet style luncheon with vegetarian op-tion, and three credit hours of coursework from the NMPA Cultural Competence/Ethics webpage at www.nmpa.com. Participants ar-

riving more than 15 minutes after the scheduled starting time of the workshop or departing prior to the end of the workshop will not receive CE credits. No partial credit will be awarded. Cancellations made by September 30 receive

a full refund. Refunds cannot be issued for cancellations made after that date.

ONLINE CREDIT HOURS: When you register for this workshop — either online at www.nmpa.com, by mail or by phone at 505-883-7376 — you will receive a confirmation which will include a username and password to access NMPA’s Cultural Competence webpages. Included in your workshop fees are three hours of online cultural diversity CEUs from the website. Choose any combination of courses to total 3 hours, or if you wish to take more than three hours, call the NMPA of-fice and you can purchase additional online hours.

You can complete the online coursework before the conference and pick up your home-study CEU certificate at the workshop on Oct. 14, or you can complete it at a later date and we will email your home-study certificate to you. All attendees will receive a CEU certificate for 6.5 hours of Category I continuing education credit at the workshop.


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NMPA 2011 Fall Conference Friday, October 14, 2011

New Mexico

Psychological Association

Psychological Practice

in Primary Care:

An Integrated Model

Friday

October 14, 2011

Indian Pueblo Cultural Center

Albuquerque, NM

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SCHEDULE: 8:00-8:15 Registration, coffee, tea 8:15-8:30 Welcome and Introductions: NMPA President Elect Tony Kreuch, PsyD, Executive Director Amelia Myer 8:30-9:30 KEYNOTE—Psychological Practice in Primary

Care: Towards a Collaborative Model James H. Bray, PhD, 2009 APA President 9:30-10:30 Understanding the Psychobiosocial Model Elaine S. LeVine, PhD 10:30-10:45 Break 10:45-12:00 Consultation and Collaboration in the Treatment

of Chronic Illness, Ann Waldorf, PhD 12:00-1:30 Luncheon, Awards, NMPA Business Meeting —

1:30-2:30 Cultural and Diversity Considerations: Collaboration in Rural Settings in New Mexico— Medicaid/Federal Qualified Clinics

Neil Bowen, PhD 2:30-3:30 Psychological Assessment and Evaluation in Primary Care Setting, Eric Levensky, PhD 3:30 -3:45 Break 3:45 –5:00 Panel: The Role of the Prescribing Psychologist In Primary Care: Focus on Rural Implications

Moderator: Elaine LeVine, PhD

Discussants: James Bray, PhD Marlin Hoover, PhD, Lia Billington, PhD

5:00 Closing

“Psychological Practice in Primary Care: An Integrated Model”

Mail In Registration Name/Degree__________________________________________ Address______________________________________________ City, State, Zip_________________________________________ Telephone______________Email__________________________ Circle all appropriate: Member—$145 Non Member—$180 Student—$95 Check VISA MasterCard Credit Card # __________________________________________ Expiration Date ___________ Sec. Code ________________ Signature_____________________________________________

Mail to: NMPA, 8205 Spain NE, Suite 202, Albuquerque, NM 87109

NMPA Members $145

Non Members $180

Students $95

9.5 hours of continuing education credit for NM psychologists, counselors and social

workers. (including six and a half hours of Category 1 credits and 3 hours of Category

2 home-study credits)

LUNCH: homemade salsa with tortilla chips, salad,

red and green chili chicken enchiladas, Spanish rice, pueblo beans, tortillas, dessert,

ice tea, hot tea, coffee

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Register for 2011 Fall Friday ForumsRegister for 2011 Fall Friday ForumsRegister for 2011 Fall Friday Forums

Albuquerque September 30 - “Neuropsychological and Neuroimaging Correlates and Current Conceptualizations of ADHD and Bipolar Disorder in Children" pre-sented by Rick Campbell, PhD, Andrea Sherwood, PhD, and John King, PhD of UNM Department of Psychiatry, Center for Neuropsychological Services. (4 contin-uing education credits) There has been considerable attention and controversy regarding the childhood psychiatric conditions of ADHD and Bipolar Disorder over the past decade. Recent research regarding the epidemiology, developmental course and neu-ropsychological and neuroimaging findings of these disorders in children will be reviewed. Current conceptualizations of these disorders and how these are reflected in proposed DSM-V modifications will be presented. (1-5 PM, Kaplan Classrooms, 8205 Spain NE, Albuquerque)

Albuquerque October 7 - "Fetal Alcohol Spectrum Disorders: Diagnosis, Neurocognitive Profile and Interven-tions" presented by P.W. Kodituwakku, PhD and Louise Kodituwakku, PhD, Clinical Psychologists. (4 contin-uing education credits) Participants will learn about the basic diagnostic criteria for Fetal Alcohol Spectrum Disorder. P.W. Kodituwakku will review the research currently underway to develop a neurocognitive profile for children affected by prenatal alcohol exposure. Intervention techniques that are effective with FASD children will be reviewed and discussed. You will have an opportunity to review case profiles to apply the criteria presented. 1-5 PM, Kaplan Classrooms, 8205 Spain NE, Albuquerque.

Albuquerque October 28 - “Aging: Navigating the Final Frontier” presented by Tom Dimperio, PhD and Rhon-da Dimperio, RN (4 continuing education credits) What is it like for the person who is aging, becoming older, losing capacity? The presenters will provide an overview of evidence-based practices in geriatric mental health care. It is important to know what you don’t know about aging and dementia. You will learn to recognize signs of cognitive decline, learn what it is like for the aging person and their families, and learn how to identify and access resources. 1-5 PM, Kaplan Classrooms, 8205 Spain NE, Albuquerque. Santa Fe November 4— Aging: Navigating the Final Frontier” presented by Tom Dimperio, PhD and Rhonda Dimperio, RN. (4 continuing education credits) Same workshop as presented in Albuquerque October 28 . 1-5 PM, 2nd floor auditorium, Medical Dental Building, 465 St. Michael's Drive, Santa Fe.

Register online with MasterCard or VISA or

Call (505) 883-7376 and speak to staff or leave a message with your phone number and we will get back to you, or

Tear out and return the registration form on the next page with your credit card information or check made payable to New Mexico Psy-chological Association, and mail to: NMPA, 8205 Spain NE, Suite 202, Albuquerque, NM 87109.

Sorry, we can’t take reservations without payment. Cancellations must be made the Wednesday before the presentation for a full re-fund or transfer of your payment to another Friday Forum. You must attend the entire session to receive any CE credit. No partial credits will be given.

8205 Spain NE

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Member: $65, $55 for 3 Nonmember: $85, $75 for 3

Student: $45, $35 for 3

Registration is open for the 2011 Fall Friday Forums. Albuquerque forums will be held at the Kaplan Class-rooms, 8205 Spain NE, Albuquerque, First Floor. Santa Fe Forum will be held at the Medical Dental Building, 2nd Floor, 465 St. Michael’s Drive, Santa Fe.

Albuquerque Forums map

Upcoming 2011 Upcoming 2011 NMPA Events NMPA Events

Please email [email protected] to check on times and dates as meeting times may change

September 24

NMPA Board and Executive Committee meetings

September 30 Friday Forum: “Neuropsychological and Neuroimaging

Correlates and Current Conceptualizations of ADHD and Bipolar Disorder in Children”

1-5 pm, 8205 Spain NE, Albuquerque

October 7 Friday Forum: "Fetal Alcohol Spectrum Disorders: Diagnosis, Neurocognitive

Profile and Interventions" 1-5 pm, 8205 Spain NE, Albuquerque

October 14

NMPA Fall Conference: “Psychological Practice in Primary Care:

An Integrated Model” Indian Pueblo Cultural Center, Albuquerque, all day

October 19

Executive Committee meeting

October 28 Friday Forum: Aging:

Navigating the Final Frontier” 1-5 pm, 8205 Spain NE, Albuquerque

November 4

Santa Fe Friday Forum: “Aging: Navigating the Final Frontier”

1-5 pm, Medical Dental Building, Santa Fe

November 12 Las Cruces SIAP/NMPA Workshop

Broadening our Reach: Psychologists’ Roles in the Next Decade”

Noon to 3 pm, 169 Milton Hall, NMSU

November 16 NMPA Executive Committee meeting

December 14

NMPA Executive Committee meeting

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Register online or clip this registration form and mail to NMPA, 8205 Spain NE, Suite 202,

Albuquerque, NM 87109.

Credit Card #

Signature

Exp. date

Visa

Method of Payment

Check MasterCard

Please check date and circle category

Oct 28 $65 $85 $45

Total

NMPA Member

Non Member

Student

Name

Phone

Email

Sec. Code Billing address zip code

Nov. 4 $65 $85 $45

Sept 30 $65 $85 $45

Oct 7 $65 $85 $45

Discount if you register for 3 forums!

$55/ea $75/ea $35/ea

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Greetings! Please let me introduce myself. My name is Nicole Duranceaux, and I am the current Early-Career Psychologist Representative for the New Mexico Psychological Association (NMPA). NMPA is the organized voice of psychology in New Mexico, and we are committed to the advancement of psychology as a science and profession as well as the promotion of human well-being. I am writing to personally extend an NMPA welcome and bring some exciting oppor-tunities and services to your attention. Consistent with the American Psychological Association’s definition, NMPA recognizes Early-Career Psychologists as those within 7 years of earning their doctoral degree. We are also including psychology graduate students in our ECP initiatives. NMPA recognizes the special circumstances facing ECPs as they enter into practice, and has been actively working initiatives to help address these needs. In 2009, the Board of Directors appointed its first ECP Rep-resentative, and the ECP committee has continued work in the following areas: Career Exploration, Development, Education, & Training

Tips for finding post-doctoral supervision necessary for licensure

Broader exposure to opportunities/sectors in which psychologists can work

Information and problem-solving related to insurance panels

Ethics and risk-management education regarding liability issues

Balancing work & family life (domestic duties, childcare, eldercare, etc.)

―Lending Library‖ of EPPP study materials

Formal recognition of recently-licensed psychologists at the Fall Conference.

Debt-Related Issues

Reduced-rate membership dues for students and those within 2 years of licensure

(extended from 2 years within receiving a doctoral degree)

Reduced-rate Continuing Education credits and training opportunities

Information regarding Financial Planning as well as practice related issues

Community

Networking with other ECPs and more seasoned psychologists

Participation in our Mentorship Program, pairing dedicated, more seasoned psychologists and ECPs in order

to help orient and integrate ECPs into the community of professional psychology

Establishing guidelines and strategies for increasing ECP’s involvement in NMPA's activities and governance,

including Fall Conference, CE opportunities, and outreach activities

Also, I would like to extend an advanced invitation to an ECP social gathering that will take place during later in the year. Current NMPA President Dr. Ken Gilman will host this event involving great food and great company. Further details will follow. Please join us in representing the concerns and interests of Early Career Psychologists, and in promoting the pro-fession of psychology in New Mexico. We would love to hear from you! If you have questions, comments, concerns, or would like to join the ECP committee, please feel free to contact me via email at [email protected] or my cell: 505-417-6407. We are excited about the Early Career Psychologist Committee initiatives and look for-ward to meeting you soon. Please check out the links below for more information! Warm Regards, Nicole NMPA: Early-Career Psychologist Page: http://nmpa.com/displaycommon.cfm?an=1&subarticlenbr=87 NMPA Facebook Page: http://www.facebook.com/pages/New-Mexico-Psychological-Association/211586175548324?sk=wall


Message from NMPA’s ECP Nicole Duranceaux

Nicole Duranceaux, PhD

mailto:[email protected]

http://www.facebook.com/pages/New-Mexico-Psychological-Association/211586175548324?sk=wall

http://www.facebook.com/pages/New-Mexico-Psychological-Association/211586175548324?sk=wall

Book Review The Emperor’s New Drugs: Exploding the Antidepressant Myth

The Emperor’s New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch. Basic Books, 2011 By Frank L. Spring, PhD Irving Kirsch, a British researcher and clinical psychologist, set out to study placebos in 1995. Unfortunately for Big Pharma, his attention turned to antidepressants. This well-researched and readable book gives us a fascinating look at the world of pharmaceutical research and regulatory oversight. Kirsch focuses on antidepressants from the point of view of the placebo expert seeking to tease out the effect of antidepressants from place-bos. Kirsch relies on meta-analyses of extensive drug studies to support his conclusions and throughout the book cites study after study to buttress his points. In the end, Kirsch reaches the conclusion that antidepressants work, but they work pri-marily as placebos. Along the way, he makes a rather convincing case that the ―chemical imbalance‖ hypothesis, as we know it, is probably false.

Placebos. One of the delights of this book is Kirsch’s exploration of placebo research, which reveals the potency of placebos in medicine, at least that part of medicine subject to psychological impact. Placebos do not have much po-tency in treatment of diabetes or infertility. But with pain or depression, hide and watch. A brand-name placebo is better than one presented as generic; four per day are more effective than two; the more expensive placebo is better than the cheap; a placebo injection beats a pill. Better still is placebo surgery. Open the patient up, do everything but the arterial surgery for angina, then sew the patient back up. Find a success rate of 83 per cent, statistically no different from the actual procedure itself, which gave 73 per cent success. As one beneficiary of the placebo surgery stated, ―I can do anything except hard lifting…using maybe one nitro a week. I used to need fifteen a day. Believe I’m cured.‖ And we believe you believe. Research on antidepressants. Kirsch delights in spinning tales of the less than scientific development of antidepres-sants, entertaining us with stories like: Early antidepressants such as imipramine were never subjected to placebo-controlled trials, but were accepted as effective based on ―clinical impressions‖. Proponents hypothesized a ―chemical imbalance in the brain‖ causing de-pression, but never established one in the lab. Monoamines, notably serotonin and norepinephrine, became identified as the out-of -balance neurotransmitters (too much reuptake) causing depression, so drugs were manufactured to prevent their reuptake from the synapse. Inter-estingly enough, when normal subjects experienced depletion of serotonin or norepinephrine, they did not become depressed. Drugs designed to increase serotonin or norepinephrine curiously showed the same effectiveness, with no explanation why. A drug designed to increase both at the same time was equally effective, but no more effective than drugs designed to increase either one alone. Bupropion didn’t affect serotonin at all and was equally effec-tive. Then, the French (those French!) designed an antidepressant that enhanced the reuptake of serotonin, so that there was less, not more of it in the synapse. The drug, tianeptine, showed virtually the same response rate as SSRIs and tricyclics. Why do you get the same result if you add serotonin, leave it alone, or take it away? Drugs not expected to relieve depression, such as thyroid hormone, opiates, sedatives, stimulants, and some herbal remedies all have about the same effect as antidepressants in clinical trials. What these drugs have in common is that they all cause side effects. Approximately forty-per cent of drug trials do not get published, according to the Swedish Medical Products Agen-cy. Those favorable to a drug company’s product do tend to get published, creating a ―publication bias‖. Through the Freedom of Information Act, Kirsch obtained unpublished studies submitted to the FDA. These he added to his

(Continued on page 11)

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meta-analysis of drugs such as Prozac, Effexor, and Celexa. Even then, some of the data were missing. He re-ceived full data on studies concerning Paxil when GlaxoSmithKline was required to provide them as part of a settle-ment of a lawsuit brought by the State of New York. In these placebo-controlled trials, meta-analysis showed that antidepressants perform better than nothing and slightly better than placebos, but the difference is clinically meaningless, worth about two points on the fifty-one point Hamilton Scale. Kirsch suggests that the difference may result from what he calls ―breaking blind‖. Since the real drug causes side effects and the placebo does not, some subjects may perceive that they are taking the real drug, thereby ―breaking blind‖ and enhancing their expectation of gain. Thus, he calls the drug an ―active placebo,‖ or ―an extra-strength placebo‖. Along the way, Kirsch regales us with more stories of how the drug companies have hidden numerous trials show-ing no difference between their SSRI and placebos, how regulators have colluded with them, and how medical re-searchers have been bullied into silence. But Kirsch is a researcher, not a polemicist. He is at his best when he argues the historical lack of proof for the ―chemical imbalance‖ hypothesis of depression and when he expounds on the nature of placebos and their research history. By the end of chapter five, he has made a pretty convincing case against monoamine deficiency as the cause of depression. Having made that case, Kirsch fails to admit that he has not made the case against other possible kinds of chemical imbalances, neurotransmitter driven or otherwise. He posits depression as a learned phenomenon, a tendency to over-read negative events and to expect failure and misery. Just as a placebo pill is swallowed with the expectation of improvement, the depressed person views his experience with the expectation of unhappiness. Depression is a ―nocebo‖, the opposite of placebo. It calls forth negative expectation, bleeds out hope and saps energy. Whatever the merits of this position, and it makes sense to many of us, Kirsch has still failed to show that some special brain mechanism may be causing depression, especially severe depression, in some people. We just do not know what that mechanism is. Even so, he succeeds in calling Prozac, Zoloft, Welbutrin, Celexa, and their like into question as possibly nothing more than upmarket sugar pills. Well, so what? Should we tell our clients to save themselves some expense and side effects and just stop taking these placebos? Kirsch says no, not necessarily. He does not buy the argument that patients should be fooled with prescriptions of chemically useless pills, even though they benefit from the active placebo effect. Such deception would breach the good faith clients expect of their therapists. Nevertheless, he considers it unwise to advise a client to discontinue use of an ―active placebo‖ without a physician’s guidance. Kirsch appreciates the clinician’s dilem-ma, but he fails to resolve it, except by passing the buck on to the physician. Treatments that work. Kirsch goes on to describe non-placebo treatments available for depression which are more powerful and more durable than antidepressants. These include several kinds of psychotherapy, psychoeducation-al literature, and physical exercise. A number of psychotherapies, including cognitive behavior therapy, interpersonal therapy, short-term psychody-namic therapy, and non-directive supportive therapy, have shown treatment effects with depressed clients. The differences in effect have not been large, although cognitive therapy appears to be more durable in effect. Among the advantages of all the psychotherapies is relapse prevention. Kirsch points out that learning in therapy creates changes in brain function, the mind and brain changing in concert. He attributes the higher relapse rates of persons treated with antidepressants to a reversion back to the nocebo effect of negative expectations when the drug is re-moved. On the other hand, persons treated with psychotherapy have learned coping skills for dealing with negative moods and situations and these skills endure. Kirsch points out that psychotherapy should be added when a patient is on an antidepressant regimen, but if the client is already in therapy, the gain from adding medication is insignificant. While counterintuitive, Kirsch claims that costs of short-term psychotherapy are less than costs of antidepressant medication, when the need for continuing care and treatment of relapse are taken into consideration.

(Continued from page 10)

(Continued on page 12)

The Emperor’s New Drugs continued


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2 buildings, 4+ acre campus, furnishings, equipment, 25+ years practice tenure.

Hattiesburg, MS area. Contact Robert T. Jackson, Sr.

Phone: 601-264-3309 or fax: 601-264-6066 for information and pictorial description.

In discussing the other alternatives to antidepressants, Kirsch observes that St. John’s wort did no better than a pla-cebo in a large clinical trial sponsored by the NIH, but neither did Paxil. Of course, the NIH held the negative result against St. John’s wort, but not Paxil. A British study on the antidepressant effects of exercise, on the other hand, showed exercise to be as effective as medication or psychotherapy and, especially with severely depressed per-sons, these effects are long-lasting. The person just has to keep exercising. Not to worry. Walking is just as effec-tive as running and anaerobic exercise like weight training is just as effective as aerobic exercise. And exercise can prevent depression as well as ameliorate it. A study at Duke showed that exercise alone was equally as effective as Zoloft or exercise plus Zoloft for reducing depression. Moreover, at six-month follow-up, the exercise group continued to recover while the drug group suf-fered more relapses. The exercise plus drug group did worse than exercise alone. Continuing exercise has to be taken seriously for its antidepressant effect. Peter Lowensohn’s Control Your Depression and David Burn’s Feeling Good have been subjected to research scru-tiny and found meritorious, presumably because they teach social skills, relaxation, and the like. An Edinburgh study showed that physicians’ patients preferred a self-help self-hypnosis program to antidepressant therapy by 86 per cent to 7 per cent. Kirsch closes his book with a short discussion of social causes of depression, citing in particular a Chicago study wherein 85 per cent of depressed clients brought up financial distress, work difficulties, or unemployment during the first two sessions. The researchers found that clients did better if their therapists responded by focusing on these economic problems as part of the treatment. Our citizenry has plenty to be depressed about. Interestingly enough, Kirsch cites studies showing that countries like Belgium and Japan have lower rates of mental disorder than the US and UK. Such countries have a more equal distribution of income than do we and our British cousins. If income inequality leads to depression, then current trends suggest that we as a profession will have our hands full in the future. It’s just that our pockets may be lighter. The day after I drafted this review, Peter D. Kramer, author of Listening to Prozac, published a spirited defense of antidepressants in the Sunday New York Times (July 10, 2011). Kramer bases his argument in part on anecdotal evidence and makes some odd, unsupported statements, like ―Antidepressants work—ordinarily well, on a par with other medications doctors prescribe.‖ How could you support a statement that broad? He attacks Big Pharma for presenting sloppy research and the FDA for encouraging bad studies using unrepresentative subjects. Neverthe-less, Kramer cites some empirical evidence of a treatment effect beyond placebo, especially with subtypes of de-pression, notably severe depression. He argues for psychotherapy as the primary treatment of mild depres-sion. Obviously, Kirsch’s word will not be the last. In the future, we can at least hope for more scrutiny and better-designed research on antidepressants. The Emperor’s New Drugs: Exploding the Antidepressant Myth makes for a fun, meaty read and a quick one; it co-vers only 226 pages, and provides a wealth of citations. Enjoy reading it, but remember, you may only be enjoying the holding of a book in a quiet place. Without a controlled study, you can never know.

The Emperor’s New Drugs continued


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Janice K. Griffin, Ph.D. Licensed Clinical Psychologist

2901 Juan Tabo Blvd. NE Suite 14 Albuquerque, NM 87112

Ph: (505) 554-1882 Fx: (505) 554-1821

Specializing in Family Forensics Parent Coordination, Mediation,

Court ordered Therapy Clinical Consultation Children, Adolescents and Adults


College Drinker's Check-up Program Our paper that presents the outcomes of two randomized clini-cal trials of the College Drinker's Check-up is now in press in the Psychology of Addictive Behaviors. The abstract of the pa-per should be posted online in the next few weeks. If you're not a member of the Addictions Division (50) of APA or a subscriber to PAB and would like a copy of the paper you can email me backchannel at [email protected]. A summary of the results is also available on our web site for the program at www.collegedrinkerscheckup.com Reid K. Hester, Ph.D., Director, Research Division Behavior Therapy Associates, LLP

Crisis Support Consultant

Supportive Solutions, Inc. is recruiting for MH professionals to provide crisis response services

In the business setting.

Qualifications: Masters degree or higher in a MH related field.

Licensed to practice independently Malpractice insurance - 1million/3 million

Supportive Solutions will train those interested. Fee structure based on experience.

Submit applications at: www.supportive-solutions.com/application.htm Questions?: 800.982.8522 or email: [email protected]

Children’s Grief Center of New Mexico Moves to a New Location The Children’s Grief Center of NM, 3001 Trellis NW, Albuquer-que has moved to a new and larger home in Albuquerque. The new location co-locates with All Faith’s Receiving Home at their north valley Albuquerque campus. This 501c3 non-profit center provides groups for those coping with a loss through death in the immediate, or very close, family. Support groups are primarily for children, teens and young adults, ages 5 - 25, but there are also co-occurring groups for the parents who bring their children to the center. For more in-formation call CGC at 323-0478, or visit their website at chil-drensgrief.org.

2011

New Members

Joan Scott, PhD Stephanie Howell, PsyD Shelly Leiphart, PsyD Christina Vento, PsyD

Kevin McGuinness, PhD Mary Kaven, PhD

Rebecca Mueller, PhD Michael Tilus, PsyD

Marycatherine Smith, PsyD Tanya Ramos, PhD

Jo Rittenhouse, PhD Valerie Valle, PsyD Linda Powers, PhD Nesha Morse, PsyD

Jennifer Rielage, PhD Gail Feldman, PhD

Osvelia Deeds, PhD Bruce Hutchison, PhD

Charles Huber, PhD Rhonda Polakoff, PhD Donald Kalsched, PhD Diane Williams, PsyD Robert Mayfield, PhD

Earl Sutherland, Jr, PhD James Shields, PsyD

Student Members

Rae Littlewood, PhD

Rebecca Osterhout, PhD Aaron Joyce, PhD

Manuela Mondloch, MA Lolita Robbins, PsyD

Jill Ryan, PhD Lisa Lande, PhD

Associate Member

Rex McReynolds, MSW

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http://www.collegedrinkerscheckup.com

http://www.supportive-solutions.com/application.htm


http://childrensgrief.org

http://childrensgrief.org

New Mexico Psychological Association 8205 Spain NE, Suite 202 Albuquerque NM 87109

REGISTER ONLINE AT WWW.NMPA.COM FOR FALL CE!

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NMPA Online Ethics and Cultural Courses Check out NMPA’s Online Ethics and Cultural Diversity Courses at www.nmpa.com. Call the office to get the username and password. No need to pay for the courses until after you have viewed them. We will be adding more online ethics coursework this fall. And take a look at the streaming videos, also online and available for Category II CE credit. Each of the videos has a separate password to check with the NMPA office to get access information. Here is a sample of both cultural diversity and ethics courses: Cultural Diversity—New Mexico History and Culture, Part I (3 CE Credits). Part I comprises 17 essays and historical research written by New Mexico historians. These materials have been pre-selected from the New Mexico History Website of the offices of the State Records and Archives, and the State Historian. The sequence of essays in (#s 1-17) provides a unique description of life in NM between the 12th and 18th centuries. Cultural Diversity—New Mexico History and Culture, Part II. (3 CE Credits). Part II comprises 10 essays and historical research written by New Mexico historians. Included are three video streams. The sequence of essays and video streams (#s 18-30) look at the process of slavery and the effects of change agents of the federal govern-ment prompting forced assimilation among Native American groups, coupled with the impact of these changes among all ethnic groups in cultural, educational, and economic patterns of life (between the 18th – 20th centuries Ethics— Guidelines on Multicultural Education, Training, Research, Practice, and Organization-al Change for Psychologists (American Psy-chological Association). (3 CE Credits) Ethics— Psychological Treatment of Ethnic Minority Populations (3 CE Credits)

NMPA’s Santa Fe Group Meets

NMPA’s Chapter II (Santa Fe/Northern New Mexico) has re-cently reorganized and now has a listserv, plans continuing education workshops and meets periodically in Santa Fe. If you would like to participate in the Chapter II meetings or join their listserv, email [email protected] with your request.

In This Issue: Katherine Nordal and James Brayc.ymcdn.com/sites/ Tom Dimperio, PhD and Rhonda ......

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