Dr. Lukasz Konopka

A wave of change is surging through the field of behavioral science, expanding our understanding of brain function and its relationship to mental illness. Where we once relied on our carefully honed observation skills to identify and define psychological disorders, we now have available to us a variety of advanced technologies that can be used to explain brain functions long considered mysteries. The use of neuroimaging—including tools such as EEGs—represents a prime example of how far we have come in understanding behavior.

In the early days, we found it impossible to define functional brain networks and their role in the expression of behavior. Only now can we relate brain function to normal and pathological states. As a result, we enter a new era where behavioral correlates can be defined by our understanding of normal and abnormal brain function. It is an approach that requires us to look at each patient and to design highly individualized treatment plans, rather than using a one-sizefits- all therapy plan.

Without knowing the biological underpinning of a disorder, our therapeutic approaches become no more precise than a shot in the dark or the flip of a coin.

I offer the example of two patients with clinical depression and identical depression measure scores. Although they appear clinically similar, we still may find they have different biological abnormalities that produce distinct responses to the same therapeutic interventions. Without knowing the biological underpinning of a disorder, we cannot know what we are treating: our therapeutic approaches become no more precise than a shot in the dark or the flip of a coin. It is not surprising then that for a number of clinically defined populations, published data reports significant pharmacological treatment failures and placebo responses.

Consider the issue of Post-Traumatic Stress Disorder, which was long conceptualized as a behavioral-psychological disorder without biological underpinnings. True, the work of a few researchers, such as Douglas Bremner, shed some light on the physiological manifestations of PTSD. Bremner used MRIs to identify changes that occurred in the region of the brain that plays a central role in memory, PTSD patients. However, the changes that he noted—specifically, a shrinking of the brain tissue, which could be correlated with a loss of memory—bear similarities to those noted in patients diagnosed with depression, making it impossible to use this single physiological factor as a basis for PTSD diagnosis. While the use of imaging has helped us take great strides in diagnosis and treatment, more research is needed to use these technologies to their greatest advantage.

During the years I spent as director of clinical neuroscience at Hines VA Hospital, my colleagues and I learned a great deal about PTSD using neuroimaging technologies. We learned, for example, that patients on the PTSD spectrum have unique electrophysiological measures (EEGs) that can be helpful in deciding on a course of treatment that will be effective. Another imaging technology—Single Photon Emission Computed Tomography (SPECT)—was used to identify blood flow patterns. SPECT data provided us with a wealth of new information; we could use the patterns to predict the success of electroconvulsive therapy in patients whose depression had thus far been resistant to treatment and, in another study, we used the information to identify patient subpopulations with cocaine abuse histories. These findings open a number of new pathways for us; by becoming increasingly aware of various patient subpopulations, we will be able to design more precise treatments for them.

With some frustration, one might view these new technologies as the more accurate way to define and treat specific psychological problems; they may ask why we cannot just rely on biology instead of the more traditional observation methods. I believe the fundamental issue is that the development of the diagnostic classifications that are widely used today came about long before the availability of brain imaging, and well before discoveries in the fields of behavioral neurology, biological psychiatry, neuropsychiatry, and clinical neuroscience. By their very nature, these classifications lack the precision necessary to describe exactly what is happening to the brain. So the brain-to-behavior approach that is driving my work—and the work of other neuropsychologists— is far more complicated than simply reversing the process. We have a long way to go in bringing the fields of biology and psychology together, but the potential is great.

We must be prepared to ride the wave of change that is redefining behavioral science. I strongly believe we must shift our thinking and train clinician-scholars in the field of psychology by exposing them to sound scientific inquiry and brain-related sciences. We should also expose students to objective clinical research that relies on the scientific approach and struggles with data that relate brain function to behavior. To this end, I am very excited by our new Applied Behavior Analysis (ABA) program with its rigorous assessments and precisely measured outcomes; I see tremendous opportunities for research collaboration among imaging, biomarker-based approaches, and ABA. ABA trains careful observers with a keen eye for behavior quantification and outcome measurement. One can imagine how well clinicians could develop patient-specific therapies when using careful therapeutic evaluation, imaging, and acute behavioral interventions. With this approach, we could design interventions that target dysfunctional networks while using the patient’s existing strengths.

Dr. Ellis Copeland, chair of the Department of School Psychology, was quoted in a Chicago Parent magazine story titled “Taking the Stress Out of School” (7/25). 

Dr. Nancy Davis, associate vice president of academic affairs, offered commentary for a Forbes.com story about people who embellish on their resumes. The story also ran in the Sydney Morning Herald (6/11). 

Dr. Todd Dubose, assistant professor of clinical psychology, appeared on the National Geographic Channel program “The Final Report.” Dr. Dubose discussed the psychology of cults, particularly the story behind the Heaven’s Gate cult from the late ‘90s (9/29). 

Dr. Michael Fogel, chair of the Forensic Psychology Department, was quoted in The Daily Journal about a criminal case in Will County (5/24). 

Dr. Evan Harrington, associate professor of clinical psychology, contributed to an EDGE Boston story titled “Gay Panic Defense Fading in Murder Cases” (7/17). 

Dr. Christoph Leonhard, professor of clinical psychology, was quoted in a Chicago Tribune story about people who compulsively collect recipes (6/4). The story also appeared in the Lincoln (Neb.) Journal Star (7/16). 

The Chicago School received mention on the WBEZ Chicago Public Radio program Worldview in a segment featuring Fr. Paul Satkunanayagam, S.J. Fr. Paul talked about his work to deliver counseling services to people in Sri Lanka and about his work with Dr. Michael McNulty, a Chicago School faculty member. 

Dr. Daniela Schreier, assistant professor of clinical counseling, discussed stress and economic anxiety for a Medill News Service story (10/7). She also was quoted in a Dallas Morning News story about people losing weight after a painful divorce (10/6). 

Dr. Hector Torres, Center for Latino Mental Health coordinator, appeared on WBEW FM-89.5 to discuss the center and The Chicago School’s Latino mental health initiative (9/11). The center was profiled in the Columbia Chronicle, a South Loop weekly (9/15). 

Dr. Debra Warner, assistant professor of forensic psychology, contributed to an article about negative self talk that appeared on moodletter.com, a website dedicated to mental health (10/8). She also was quoted in a Therapy Times article about political correctness and the patient-therapist bond (9/15). 

Dr. Nancy Zarse, associate professor of forensic psychology, was interviewed by ABC7’s Kevin Roy for a feature story about campus shootings (8/17).

Long touted as “man’s best friend,” dogs may be playing an even more important role in the lives of academically at-risk inner-city children in Chicago. Dr. Robert Clark’s research shows that pet canines may be improving literacy skills, school attendance, and behavior for students aged 7 to 9 in under-performing schools throughout the city.

The research, which was co-presented by Dr. Clark, professor of school psychology at the Chicago Campus, and Dr. Corinne Smith, a school psychology adjunct faculty member, at the annual conference of the Midwest Psychological Association. in May, reported on work being undertaken by SitStayRead, a Chicago nonprofit dedicated to improving literacy in academically underserved children.

“Animals have been used in therapeutic situations for years,” Dr. Clark says. “Traditionally they were used with traumatized populations, but SitStayRead introduced them into classrooms as facilitators for academic instruction. What we found is that they definitely have a calming effect: children behave better, their attendance improves, and their reading improves over comparison groups who don’t have the interaction with dogs.”

School psychology has taken the lead in program evaluation for the project, which is a relatively new approach to literacy. As executive secretary of the International School Psychology Association, which has its headquarters office at The Chicago School, Dr. Clark has played an integral role in that research. “Many of the children who live in the inner city don’t have pets of their own; dogs are a novelty for them,” Dr. Clark says. “SitStayRead is a very structured program that requires children to behave and perform in a certain way. Often these kids will do for dogs what they won’t do for us.”

Analyzing “Psycho”

Four decades after Alfred Hitchcock’s 1960 thriller “Psycho” began captivating and horrifying audiences, Dr. Jim Iaccino has put a name to the forensic psychology classification that he believes defined Norman Bates, the mother-obsessed serial killer at the center of 109 minutes of suspense and blood-letting.

An associate professor of forensic psychology at the Chicago Campus, Dr. Iaccino has begun presenting his findings, most recently at the American Popular Culture Association Conference in San Antonio, Texas, in April, where he spoke on “Applying a Serial Killer Typology to the Psycho Franchise: Norman Bates as a Visionary Killer on a Mission.”

The title of his presentation offers a clue into his conclusions—that Bates actually falls into two serial killer classifications: the visionary and the mission-oriented killer. “The visionary is someone who typically explodes, leaving a mess—and clues—behind, while the mission-oriented killer takes it upon himself to rid the world of people who possess an undesirable trait—in Norman’s case these were people who remind him of his mother,” Dr. Iaccino says. He explains that the opportunity for dual diagnosis arises when the entire four-film series is viewed, showing Bates as a disorganized, impulsive killer in Hitchcock’s original movie and as a mission-driven murderer who in later “Psycho” films continually targets people with “mother” characteristics.

“Can a person shift from a visionary to a mission killer? I don’t know why not,” he says, adding that he thinks a lot can be learned from viewing and analyzing films. He notes that while little research has been done in the area of analyzing serial killers portrayed on film, it is an area that has recently gained traction with the American Psychological Association through its Division on Media Psychology.

“’Psycho’ remains a classic in horror films—one that offers a very good portrayal of the types of killers out there,” he says.

Presentations

Dr. Claude Barbre, associate professor, Clinical Psychology, Chicago, presented “The Artists Appoints Herself Artist: Otto Rank and Existential–Humanistic Therapies: at the national conference of APA’s Society for Humanistic Psychology in April. He also presented “The Background of Music of Being: On Listening” at the national conference
of the Philosophy of Education Society in St. Louis in March 2011.

Dr. Michael A. Barr, associate professor, Business Psychology, Online, copresented a paper, “Measuring Outcomes of Orthognathic Surgery From a Multidisciplinary Perspective,” at the 68th Annual Meeting of the American Cleft Palate-Craniofacial Association in San Juan, Puerto Rico.

Dr. Robert Clark, professor, School Psychology, Chicago, gave the keynote address at the Second International Conference on School Psychology in Vietnam, and presented a paper, “International Accreditation Standards for School Psychology,” in Hue, Vietnam.

Dr. Ellis Copeland, dean of academic affairs, Chicago, spoke in April 2011 at Arizona State University’s TEDx ASU West event on Redefining Video Games at the New College of Interdisciplinary Arts and Sciences.

Dr. Todd DuBose, associate professor, Clinical Psychology, Chicago, served as a moderator for a panel discussion on Medard Boss and the First Systematic Approach to Existential Psychotherapy at the fourth annual Society for Humanistic Psychology Conference, Division 32, of the American Psychological Association in Chicago. He also presented on “Immeasurable Dasein in a Measuring World” at the International Federation for Daseinsanalysis General Assembly in Athens, Greece, in February 2011.

Dr. Eleazar Cruz Eusebio, assistant professor, School Psychology, Chicago, was invited to present a paper, “Incidental Effects of Students Simulation of Tic Behaviors on Working Memory and Comprehension,” at the International Learning and the Brain Conference May 6 in Chicago.

Dr. Robert Foltz, assistant professor, Clinical Psychology, Chicago, presented on “Adolescent Subjective Experience of Treatment” at the National Conference of the American Association of Children’s Residential Centers in April 2011, in Seattle. He also presented “The Teen’s Perspective of the Residential Treatment Experience” at Reclaiming Youth International, Black Hills Seminar in June 2011.

Dr. Noelle K. Newhouse, associate professor, Industrial/Organizational Psychology, Online, will present on “Development of the Thurstone Mental Alertness (TMATM) Express” at the annual convention of the Association for Psychological Science in Washington, D.C.

Dr. Donald Schultz, associate professor, Marital and Family Therapy, Los Angeles, presented on “Successful Aging: Life Transitions and Finding Fulfillment in Your Later Years” at the Food For Thought Speakers Program, presented as a community service by the Santa Monica Co-Opportunity community organization in March 2011.

Dr. Sandra Siegel, associate professor, and Dr. Linda Robinson, both Counseling, Chicago, presented a paper, “Understanding the History of Chicago’s West Side African American Community: Clinical Implications,” at the Illinois Association of Multicultural Counseling/Division of Illinois Counseling Association.

Dr. Richard Sinacola, associate professor, Clinical Psychology, Los Angeles, presented an “Update on Psychopharmacology: The Latest Medications for Depression, Anxiety and Psychotic Conditions” at the California Association of Marital and Family Therapists 47th Annual Conference in San Francisco in May 2011.

Dr. Orlando Taylor, president, Washington, D.C., presented a paper, “Utilizing the Intersection of Race and Gender to Promote Minority Success in Higher Education: Preparing Critical Faculty for the Future,” at the European Access Network 20th Anniversary Conference for Student Diversity in Higher Education: Conflicting Realities in Amsterdam in June 2011.

Dr. Héctor L. Torres, assistant professor, Counseling, Chicago, has been invited to present a paper, “An Educational Model for the Integration of Culture and Psychology,” at the 38th Congress for Teaching and Research in Psychology in Mexico City. He also co-presented on “Teaching Latino/a Style: Addressing Challenges and Strengths of U.S. Latino/a Graduate Students,” at the 33rd Congress of International Psychology in Medellin, Colombia.

Drs. Hector Adames, Nayeli Chavez, Héctor Torres, and Fahmida Zaman co-presented a paper, “Collectively Building Bridges in the Academy: Culture-Centered Pedagogy,” at the biennial International Conference on The Teaching of Psychology in Vancouver, Canada, in July 2011.

Dr. Debra Warner, associate professor, Forensic Psychology, Los Angeles, and Dr. Loren Hill, manager, Forensic Training Institute in Los Angeles, will present “How Women Expand Personal Comfort Zones of Community/Gang Intervention Training in Los Angeles: Focus Group Findings” at the Institute on Violence Abuse and Trauma (IVAT) Conference in San Diego, September 14, 2011.

Dr. Fahmida Zaman, assistant professor, Clinical Counseling, Chicago, will co-presented two papers at the American Psychological Association in Washington, D.C. in August: “Mastering the Climb: Minority Student Mentorship at the Master’s Level,” and “Lifting As We Climb: Mentoring Diverse Students Across Educational Levels.” He will also present a symposium, “Mentoring Diverse Students Across Educational Levels” at the APA Conference.

Dr. Nancy Zarse, associate professor, Forensic Psychology, Chicago, presented at the FBI’s statewide conference on Campus Safety and School Violence in April 2011. Dr. Zarse addressed Risk Factors and Warning Indicators for Violence. Dr. Zarse also presented her project, “Holding the Classroom Hostage: The Use of a Role Play as an Experiential Teaching Technique,” at the International Scholarship of Teaching and Learning conference in May 2011. Dr. Zarse co-presented on “Extremist Groups in Prisons” at the National Mental Health in Corrections Conference in April 2011.

Publications

Dr. Eleazar Cruz Eusebio recently co-authored “Assessment and Intervention Practices for Children with ADHD and Other Frontal-Striatal Circuit Disorders” in the first edition of Best Practices in School Neuropsychology.

Dr. Elaine Fletcher-Janzen, professor, School Psychology, Chicago, has served as co-editor of the Encyclopedia of Special Education for the past 27 years. She is currently editing and authoring the fourth edition of the work. The Encyclopedia is used in university libraries in over 27 countries.

Dr. Robert Foltz recently published “Principles in Evidence-Based Standards” in the Winter 2011 issue of Reclaiming Children and Youth.

Praise

Dr. Nancy Zarse, associate professor, Forensic Psychology, Chicago received the Distinguished Faculty: Excellence in Public Service award at graduation, in June 2011. For the second consecutive year, Dr. Zarse was also named a Carnegie Scholar by the Carnegie Academy for the Scholarship of Teaching and Learning, recognizing her ongoing work using role play as a teaching technique through the Hostage Negotiation course she teaches for the Chicago Campus’ Forensic Psychology Department.

Dr. Claude Barbre received the Margaret Morgan Lawrence Award from the Harlem Family Institute in recognition of his contributions to HFI as executive director and his 20 years of clinical services to children and families in Harlem and New York City.

Recidivism rates have remained steady, despite increases in corrections spending. We gathered four Chicago School faculty to discuss issues around recidivism, from why it happens to the role of our criminal justice system to what kinds of treatment work (and what don’t). From the Chicago Campus, Dr. Kristy Kohler Kelly, assistant professor of school psychology, and Dr. Nancy Zarse, associate professor of forensic psychology. From the Westwood Campus, Dr. Jill Model Barth, associate professor of psychology, and from the Online/ Blended Program, Dr. Michael Davison, assistant professor of forensic psychology.

INSIGHT: A recent report issued by the Pew Center on the States found recidivism rates have remained consistent, around 40 percent, despite a massive increase in corrections spending. Why aren’t we seeing improvements in recidivism rates?

Dr. Jill Model Barth

DR. BARTH: I think that a lot of our system is not based on rehabilitation and education and opportunity for psychological growth. It’s based a lot on punishment.

DR. DAVISON: We’ve gotten a whole lot better at determining at the front end who we’re working with, and what risk level there is. We can do different kinds of assessment procedures, including what’s referred to in the literature as actuarial risk assessment. With most categories of sexual offenders we can run their numbers and determine right at the front end: here’s the probability of re-offense in the next five years, in the next 10 years. The research that’s been done over the years shows that treatment absolutely does make a difference. If you have two people with the same offense, but one goes to the Department of Corrections and one goes directly to probation, their recidivism rate is already lower. They know that the moment this person gets sent to the Department of Corrections, their potential to re-offend goes up. I think their transition out, the complications in their life, putting their life back together, employment, housing, financially—they just have extra layers of difficulties, which certainly are going to contribute to distress, which probably is going to impact the recidivism rates for sure.

Dr. Kristy Kohler Kelly

DR. KELLY: Speaking from a school perspective, we don’t spend enough money on prevention and early intervention, especially for targeting at-risk children who live in poverty and have other risk factors. We know there are some great programs that work. They’re really expensive, but there have been lots of cost-benefit analyses that show that we get our money back threefold if we put the money in when they’re little kiddos. We see a reduction in crime, juvenile arrest, and things like that.

DR. ZARSE: The research seems to indicate that we’re spending the money in the wrong places. Where we’re spending the money is in corrections, and we’re spending an inordinate amount of money there. But that’s not necessarily what the research is showing us would be the most effective use for our money. What the evidence would indicate is that if we target our money in accordance with the Risk-Needs-Responsivity (RNR) principle—which is much more about rehabilitation—we would see more of a return for our investments.

INSIGHT: With a criminal justice system that is more punitive than rehabilitative, how does this impact recidivism rates?

Dr. Michael Davison

DR. DAVISON: I think that the correctional system in the United States could really learn a lot from the Canadian system. One thing we know from that is that there are certain categories of offenders that are very, very responsive to treatment and interventions. There was some research that was done in the 80s, and they had a uniform set of data for everyone coming into the Department of Corrections, which we don’t have in the United States. There’s an instrument called the Hare Psychopathy Checklist. They take people who are high on this scale, put them to the side, re-run the numbers relative to a population that’s below a certain threshold, and you go, wow, you really do make a difference—we do reduce recidivism, if we target our treatment services to the right person. In the Canadian system, if somebody is very low risk, don’t provide intervention. If they have a super high recidivism rate, don’t bother treating them, because if they’re high on this construct of psychopathy, not only do our interventions not seem to make a difference, there’s some indication that they actually may increase recidivism rates. So if we put our treatment dollars towards that middle group, it does make a difference.

Dr. Nancy Zarse

DR. ZARSE: What we are finding is that if you take the higher-risk inmates and address criminogenic needs, and then address for individual differences, that’s where we see the difference. It feels counterintuitive, because for instance, early in my career, they were thinking, let’s put a lot of money into low-risk, first-time offenders, and they won’t come back. What the research shows is the odds are they wouldn’t have come back anyway. So that was a waste of money. But if you go for the higher risk individuals, treat them on the parts that actually relate to their criminal activity, that’s where we’ll receive the return.

DR. BARTH: I would also like to add a comment about the relationship between criminal recidivism and the high correlation with psychopathy. The psychopath in analytic research is defined by the uninhibited gratification, and criminal, sexual, or graphic impulses. It’s the inability to learn from past mistakes. So when we think about treatment, we have to tap into which criminals are guided by a strong repetition compulsion model. We can figure out a way to break a historical repetition compulsion by going inside and looking at the gain of the repetition.

DR. ZARSE: And I would certainly agree, if you don’t go quite so psychoanalytic, it still touches on this very popular principle these days of the RNR. What you’re getting at there is “What are the needs? What needs does this crime serve, and how else can we adjust those needs?” And also the responsivity to a specific nature. How do we address that which ties into crime as opposed to some of the things that we thought: “Well, let’s just improve their self-esteem.” If you increase the self-esteem of a psychopath, and that’s all you’re doing, you’re making for a more confident criminal. You’re not reducing crime. So that’s why you want to tie all these things together to the crime.

We don’t spend enough money on prevention and early intervention, especially for targeting at-risk children who live in poverty and have other risk factors.

DR. BARTH: Well, yes, I think that a cognitive approach can be very helpful in reducing recidivism rates, but meanwhile I just picked up the most recent recidivism rate that was posted on the BBC in September 2005. In the United States it’s 60 percent, not 40 percent. And they talked about a very high percentage among robbers, burglars, and arsonists. I think that you’re right, that a multitude of rehabilitative measures need to be made, but if we’re targeting the wrong issues, we’re in trouble.

DR. ZARSE: We know punishment is most effective when it’s immediate. Well, punishment in our society is not necessarily immediate, and in between the crime and an incarceration you may have had several other crimes that they didn’t get caught for that they made money on.

DR. DAVISON: With sexual offenders, the recidivism rate overall is nowhere near 60 percent. But there may be a specific individual that you do a risk assessment, and it’s not a question of if they’ll re-offend, it’s a matter of when they’ll re-offend. It’s better to think about them more individualized. Last night I wrote up a risk assessment on a person who is civilly committed under the Sexually Violent Persons Commitment Act in the State of Illinois, and there we have a good database that we can tap into to look at the recidivism rates with high-risk offenders specific to certain variables. The guy I assessed had male victims, he had female victims, he had younger victims, he had a little bit older-child victims, child victims, he had victims that were within his family, victims that were outside of his family. In addition to the fact that he hasn’t been in treatment in the last year, he made it real easy for me to complete this risk assessment. It’s just as high as it was a year ago, and he hasn’t done anything to mitigate any risk factors. Given the level of psychopathy I’m not sure that going to treatment would do a whole lot to reduce his recidivism rate, given the fact that he’s offended complete strangers in a public setting, all the way to family members in a very private, intimate setting.

INSIGHT: Why do some offenders re-offend?

DR. DAVISON: If somebody doesn’t have adequate educational or employment resources, we do know that that’s a factor that can increase recidivism. It makes them more dependent on the system, it makes them more overwhelmed, more vulnerable. If they don’t have the resources to manage and regulate those stresses, their risk is going to continue to be elevated.

The research is indicating that a much more cognitive-behavioral focus that looks at criminogenic needs, that looks at values, that looks at things like pro-social criminal attitudes are where we’re seeing the progress and the gains from treatment.

DR. BARTH: From a psychoanalytic treatment perspective, there are three issues that I’d like to raise. The first is something that you said earlier, about regular, healthy longings. These are people who have dependency longings. And the idea, perhaps, too, of being re-incarcerated is an experience where, even though it’s a bad way to be taken care of, there’s somebody at least that is in charge. So the idea is perhaps based on healthy needs, but in an unhealthy manner of how to achieve that. The second is about the repetition compulsion, when the person just wants to repeat over and over again, especially if the outcome at the beginning is a faulty outcome. There is a wish to act out the crime over and over again, with the fantasy that this time there’s going to be some good outcome: unlimited wealth, the idea of getting away with something. And the third issue is the idea about identification with the aggressor. In that, the only way, sometimes, that a child can identify and feel connected with early parental values and mores is to connect to some aspect of their past and identify with what punishment was done to them, then they project it onto others. And this is somebody who has very limited superego. So coming up with a treatment plan whereby guilt is unknown to these people, it’s very difficult to treat.

DR. KELLY: When we talk about children that are at risk of recommitting or committing crimes, we look at things like how early their first crime was committed—they’re more at risk if it’s at an earlier age— if they are using substances, or have some mental health issues. A crime that is more severe in nature, they’re more likely to commit another crime. But children who go to detention do far worse than those who do not. So this concept of peer deviancy training and when you plunk together students in a classroom that have behavioral disorders or emotional disorders, there is some sort of cumulative effect when you learn other behaviors from people that may be struggling with the same thing. When we talk about a child perspective, you think about what are the predictive factors for them recommitting, and how we teach those.

DR. ZARSE: What are the things that would mitigate the likelihood that they would commit a crime, and how can we strengthen those? So certainly education, we know employment, we know even strong families and strong marriages, or strong partnerships, also are factors that mitigate the likelihood. Some mental illnesses are more likely to contribute to the offending than others, but—is there treatment, and are they compliant with that treatment? And then in terms of specific treatments, the research has shown that cognitive-behavioral treatment is the most effective, which isn’t necessarily what any of us would prefer—I know that I was much more inclined to be psychodynamic, but the research is not supporting that. The research in re-offending and recidivism points to cognitive behavioral treatment.

INSIGHT: Let’s talk about treatment. You said that you’d prefer a psychodynamic approach?

DR. ZARSE: Psychodynamic is a little bit more that you’re looking at multiple facets, but you’re also looking at, you know, childhood experiences, you’re looking at more of the interpretation, and working with that in therapy. But the research is indicating that a much more cognitive-behavioral focus that looks at criminogenic needs, that looks at the values, that looks at things like pro-social criminal attitudes are where we’re seeing the progress and the gains from treatment.

DR. KELLY: I come from more of a prevention focus, so a lot of my work has been in early-childhood prevention and then also school-based prevention efforts. What we really look for as far as prevention of those types of behaviors is any kind of social emotional learning programs, so something that’s going to target social competence in children. We know that children have better social skills, peer relationships, they can make healthy decisions, they have good problem-solving skills, conflict-resolution skills—those are the types of interventions that we try to put into place with children that are most at risk. There are specific risk factors that we look for, but it’s really about building social competence before they even commit a crime. Once delinquency has happened, or there has been some sort of issue for a child, it is a little bit more protective than adult populations.

DR. DAVISON: In the online/blended program, we have an applied research project to emphasize the mindset of knowing what the literature says, being up to date on that in your area of expertise, designing your treatment plans, your interventions, your programs based on what the literature suggests, and then also having the courage to do research as well. So you can not only develop a program but you can track the effectiveness of the program. I think that’s a mindset that’s needed in our culture right now so we can know where we should put our money, what works with who, and when, and how. I know with the offenders that I work with, accountability is huge. The Mennonite Church has implemented these programs they call Circles of Accountability, COSAS, and I use that with my sexual offenders. You need a team of people around you, people who are not only there to love you and support you but also to hold you accountable, somebody that’s going to ask you the tough questions.

If we look at criminality that keeps getting repeated, we have to take into account the possibility that the more superficial cognitive-behavioral approaches may not be enough to get at some of the underlying, deep, painful issues.

DR. ZARSE: The research has shown that the relationship with the therapist, regardless of the kind of therapy, is still valuable. That warm supportive relationship is found to be a piece of the treatment. So it’s not just that it’s cognitive-behavioral and then we don’t have to worry about what kind of relationship that is. It’s also shown that that clinical relationship is important. Once you’ve identified the treatment program, still continue to provide the training for the therapist, including support groups for the therapist.

DR. BARTH: It’s the transference dynamic that occurs between the patient or the inmate or the client—whatever term you use—and the therapist, which really counts for a lot of the correction. There’s a lot of role modeling that goes on and to that, a lot of repair in terms of early history and damage. The problem is that oftentimes the psychodynamic model is not efficient in that it certainly takes longer and there isn’t enough staff to have a long-term therapeutic relationship. If we look though at criminality that keeps getting repeated, we do have to take into account the possibility that the more superficial cognitive-behavioral approaches may not be enough to get at some of the underlying, deep, painful issues. It would be very, very interesting to have a study which included both short-term and longer-term treatment and to see if there was any difference in recidivism rates.

DR. KELLY: We know that the most effective programs for kids are combination programs—those that target both the child and the family system, or the child and multiple systems, because we know that children, developmentally, don’t take care of all their needs. We know that we need to access other components that the child might need support with, whether it’s the school system or whatever, but they should have multi-systems in place.

INSIGHT: What can psychologists do, or do more of, to affect recidivism rates?

DR. DAVISON: Good data-based-assessments. Knowing what the literature says about working with this person that’s right in front of me, and I think the only way we can design the right interventions is by doing a really good front-end assessment.

DR. KELLY: I think that finding and identifying interventions that will work for students are really important, but also using data, making decisions about students with data, by screening for a risk factor that identifies the students that need more support in school settings, and then disseminating that information. One of the most helpful ways to disseminate that information is to do cost-benefit analyses. Because in this political climate, and in the climate that we don’t have a lot of money right now, we need to figure out where do we put the money, which prevention programs work well, and in what settings do they work?

DR. ZARSE: I think psychologists can educate. I think that we can be part of the voice that speaks to the value not just of incarceration but the value of rehabilitation, the value of treatment, the value of appropriate supervision.

DR. KELLY: I think stigma with mental health still plays a really big factor in why a lot of people don’t access support, and especially at an earlier age where they might be more useful or preventative.

DR. ZARSE: And along those same lines of destigmatizing is we tend to globalize, and we think mental illness in and of itself is a risk factor, for violence, for re-offending—and it’s not! So part of it is also educating as to which parts are the risk factors. And again, address those with treatment.

Moments before he signed the Affordable Care Act of 2010, President Obama mentioned to Vice President Biden that this particular piece of legislation was 100 years in the making. Also referred to as the Health Care Reform Act of 2010, it is a large step in the creation of compulsory insurance coverage and just well may be the most significant health care act since the creation of Medicare and Medicaid in 1965.

As a nation, this is not our first attempt at major reform within the field of health care. We tried to pass compulsory insurance in 1911, yet World War I quickly took center stage and the reform movement was forgotten. We tried again in 1965 and compromised with the passing of Medicare and Medicaid. In the early 1990s, President Clinton took his reform plan to the masses until it was defeated due to last-minute deals never realized and the window for bargaining slowly closing on both sides, one side happier than the other.

As I write this essay, I realize that I could certainly spin my position a hundred different ways. However, I come back to the notion that health reform isn’t about political wins or who gets paid for what. It does however, boil down to one thing: access to care. Inevitably, we are either currently consuming health services and if not, it isn’t a question of whether we need services; rather it is simply a question of when.

This exploration of health reform is not about political wrangling, rather it is a question of what exactly are we paying for and what did we get for our $950 billion price tag? In 1911, in 1965, and in the 1990s, the premise for reform was centered on the notion that compulsory, by definition, meant coverage for everyone. The great dilemma of WIFM (what’s in it for me) was satisfied across all socio-demographic boundaries. Access was to be guaranteed to all.

The title of this piece stems from the idea that at first glance, there may be more losers than winners in this particular legislative act. Touted originally as “universal health care” (another term for compulsory—just sounds less ominous), the current piece of legislation leaves an estimated 22 million Americans without health insurance.

Health insurance normally equates to health care access. Of particular concern is the double-edged sword that many individuals suffering from mental illness are often excluded from access to health services through the denial of health insurance.

How do we make sure that such a reform is distributed evenly across the masses and does not leave those with mental health needs out in the proverbial cold? Granted, we have passed parity mandates in the past, however, health data suggests that the mentally ill are not receiving nor have they received the care that they need.

In 2008, the government passed the Mental Health Parity and Addiction Treatment Act which prohibited private insurance from placing discriminatory limits on mental health. However, one key loophole that often prevented individuals from receiving the insurance coverage they needed was the idea of pre-existing conditions. Unlike physical diagnoses that seem to come and go, mental health diagnoses often remain on medical health records indefinitely, thus making the attainment of health insurance virtually impossible. Although health reform should prohibit insurance companies from denying coverage for pre-existing mental health conditions, my fear is that this will continue to happen. Enforcement of health care legislation and particularly that of mental health has often been lacking.

While I applaud our nation’s step in the right direction through its passing of health care reform, I am concerned that access to health services will again become too limited for those in need of mental health services.

Dr. Michael Barr, assistant professor of business psychology, was interviewed in Jayplay, the magazine of the University of Kansas, for a story about consumer psychology and supermarket tactics (4/29).

Dr. Michael Davison, assistant professor, forensic psychology, was quoted in a story about Colonel Russell Williams, a former Canadian air force base commander who was recently convicted for two murders, sexual assaults, and numerous counts of breaking and entering. The story appeared in newspapers throughout Canada, including the Vancouver Sun, Calgary Herald, and Montreal Gazette (10/22).

Dr. Ken Fogel, professor of clinical psychology, was interviewed on CBS 2 Chicago News for a story about why Americans seem to be increasingly rude to each other (5/7).

In an article in Youth Today, Dr. Robert Foltz, professor of clinical psychology, discussed why he believes the increasing use of anti-psychotic drugs on juvenile offenders actually interferes with the their ability to benefit from psychotherapy (10/1).

A Chicago Tribune story on career opportunities in child psychology featured interviews with Dr. Bianka Hardin, associate professor of clinical psychology and Aisha Ghori, director of career services (5/6).

Dr. Michael Komie, associate professor of clinical psychology, was quoted in an article in Crain’s Chicago Business on the emotional and relationship pitfalls of working in the office on weekends. (11/15)

Dr. Cynthia Langtiw, assistant professor of counseling psychology, provided in-depth insight for a story in Chicago Parent Magazine about how parents can support their children through the socialization process as they learn to make friends in school (7/21).

Dr. Chris Leonhard, professor of clinical psychology, was quoted in the MSNBC blog, “The Body Odd,” in a post about why we seek out and often crave the excitement of frightening experiences (8/24).

Dr. Linda Liang, Organizational Leadership Department chair, talked with ABC-News Chicago about how to develop negotiating skills—asking for and getting what you want (9/28).

In The Norwalk Hour, Dr. Charles Merbitz, professor of applied behavior analysis, discussed the value of applied behavior analysis and the BCBA certification in the context of a story about a local Connecticut woman who misrepresented that she held board certification to work with children with autism. (4/30).

Dr. Daniela Schreier, assistant professor of clinical counseling, commented in the Chicago Daily Herald that former Illinois governor Rod Blagojevich displays symptoms consistent with narcissistic personality disorder (7/5). The New York Daily News featured her in articles about whether spouses/partners who have secret bank accounts are “cheating” on their partners (10/11); a new test that predicts menopause may make women anxious (6/28); the psychological impact on children who grow up with an abusive mother (5/7); and the psychological impact of facial transplants (4/26).

Dr. Debra Warner, associate professor and lead faculty for the Clinical Forensic Psychology program in Los Angeles, was interviewed on Viewpoints, a weekly public affairs radio magazine broadcast on over 370 radio stations across the country (11/3).

On the anniversary of John Lennon’s death, Dr. Nancy Zarse, associate professor of forensic psychology, was interviewed by KTRS Talk Radio St. Louis about people who stalk and kill celebrities (12/8).

The Chicago School of Professional Psychology’s L.A. Campus was mentioned in an article about Aquil Basheer, a renowned gang intervention practitioner who received a California Peace Prize from the California Wellness Foundation. The article notes that Basheer’s organization runs the Professional Community Intervention Training Institute in partnership with The Chicago School (10/20).

For the most up-to-date list of TCSPP faculty in the news, please visit the Media Room.

Dr. Elaine Fletcher-Janzen

INSIGHT: What are some of the differences between psychology and psychiatry?

Dr. Pyles: The biggest and most obvious difference is that psychiatrists are physicians, and psychologists are psychologists. The degree for a psychiatrist is an M.D., generally, although sometimes you get D.O.’s and other kinds of professions weighing in, whereas a psychologist tends to be a Ph.D., Psy.D., or Ed.D. degree.

Dr. Fletcher-Janzen: When I first started in this profession, which was a long time ago, a lot of psychiatrists would do the actual psychotherapy or treatment. These days, managed care companies and insurance companies don’t tend to reimburse for psychiatrists doing those sorts of activities. Now most psychiatrists are much more involved in psychopharmacology and very seldom engaged in the therapeutic process. Consequently, the continuum of treatment has changed a lot in psychiatry in the last few years.

Dr. Sinacola: We’ve also seen an interesting trend in medical education: psychiatry is becoming one of the lower-paid medical specialties. And psychiatry training programs now don’t have quite the robust numbers that they had at one time, which is resulting in the inability of psychiatry to provide the amount of care that’s needed in each state. This is what led to recent developments in states like New Mexico where prescription privileges were afforded to psychologists because there was an emergency situation where even psychiatry admitted that they could not keep up with the pace of med reviews. I think someday when psychologists are doing more of the prescribing, the psychiatrists will be available for consults as specialists on unusual cases. But clearly, so far, at least in states that do allow it—New Mexico, Louisiana, Guam, the Department of Defense—psychologists are prescribing, and they are doing so safely.

Dr. Lukasz Konopka

INSIGHT: Legislation to grant prescription privileges to psychologists has been proposed in several other states, but they have not passed laws. Why not?

Funk: I think the main issue with other states is the opposition from the medical associations. In my research that was the main trend, that in every state the medical entity had much stronger lobbying forces, a lot more funding behind them, and they just were able to end our efforts.

Dr. Fletcher-Janzen: I think the major concern from the American medical establishment is that psychologists don’t have the medical training to understand the complications that can occur with prescriptions. I think legislative efforts have the scare tactic of psychologists not knowing anything about comorbidity and comorbid medical disorders and side effects. Most folks who go through training in Louisiana and other states work in conjunction with general practitioners. So, we’re not talking about psychologists going off on their own and creating high-risk conditions. It’s a very conservative approach to training and supervision.

Dr. Sinacola: If we go back to the fact of 60 to 70 percent of psychotropic prescriptions are written by a primary care physician, we also forget that the typical family physician has four weeks of mental health training. That’s it. That’s the extent of their medical training in psychotherapy and the art of mental health treatment, and they’ll be the first to admit that they know very little about it. But yet that onus falls on them.

Dr. David Pyles

INSIGHT: Then what training is necessary to prepare a psychologist to prescribe medication safely and effectively?

Dr. Konopka: My opinion is that prescribing medications is not a huge, complicated task. Particularly today since we have electronic medical records, and pharmaceutical information is available online, and we have intelligent programs that will not allow you to prescribe medications that do not fit in terms of metabolism or other interactions. So, it’s really difficult to make an error.

Funk: I think it is important to get that medical background training, to order a metabolic panel, to then understand what labs are coming back. We aren’t taught that in the general psychology programs.

Dr. Sinacola: I think that what APA and other professional groups have begun to talk about is the fact that we are looking at the minimum of an equivalent of a master’s degree to cover all those topics. But, I guess what is going on now is that some psychologists have taken the back-door approach to training by going into nursing programs. Nursing has jumped on that bandwagon and thrown open the doors with wide open arms saying, “Come on board. We want to have you.” But I think we as psychologists need to look at that and say, is that an identity crisis? What do
you call yourself when you are done? Do you call yourself a nurse practitioner/psychologist or a psychologist/nurse practitioner? I think the time is right for educational institutions, even The Chicago School, to consider these specialty programs in pharmacology for psychologists to prescribe.

INSIGHT: Why isn’t there agreement yet?

Dr. Konopka: I think many psychologists will argue that they are not working within the medical model. And psychology is a separate field unrelated to the practice of medicine. If you sell yourself as that kind of an individual, and if you present that to the public, that’s the outcome. You’re not medically trained.

Funk: I think there is also a fear from some psychologists that if not for prescription privileges, psychology will turn into psychiatry. That we’ll lose that aspect of biopsychosocial and we’ll just become biologically focused medication managers like psychiatrists are now.

Dr. Sinacola: I know of a study that says that if psychologists achieve prescription privileges, psychologists would only prescribe psychotropics—whereas psychiatrists can prescribe anything as a physician. So I think that it allows for psychology to really develop its specialty, if you’re going to become a prescribing psychologist, that you would really become an expert in psychotropic medications. A psychiatrist who wrote an article in the National Psychologist said that he believes psychologists will prescribe more judiciously because their mainstay will still be psychotherapy.

Dr. Konopka: I’m not sure that that behavior will stay. As with any new field initially, I think, there will be a conservative approach. But eventually, if your income will depend on the number of patients you see, and you can justify your existence by seeing patients for 10-minute medication management visit, I think humans have a tendency to go down to the lowest common denominator.

Dr. Richard Sinacola

INSIGHT: Are there different issues to consider when thinking about children and adolescents?

Dr. Pyles: Most psychiatrists that I’ve interacted with—if they are adult psychiatrists—are very hesitant to treat children at all, and consider child psychiatry to be a specialty. Given how little we know about the developing brain and, to be honest, how little we know about how drugs actually affect the brain, there’s much more that we don’t know than we do know, and trying to pretend that we do know anything about this is, I think, a mistake. In my practice, I see people with developmental disabilities who are on medications for decades. And in most of the drug trial studies,
when they say there are no long-term effects, they’re talking about six weeks. They’re not talking about the effects of being on an antipsychotic medication for a number of decades.

Dr. Fletcher-Janzen: I work mostly with children in the public schools, which has a dizzying array of children with various kinds of neurodevelopmental, behavioral, social, and sometimes family disorders. And the issue is that most psychoactive medications for children are offlabel. In other words, there are no evidence-based practices associated. Apart from that chilling fact, the other issue is differential diagnosis. Think of the average general practitioner who has a 15-minute appointment with a family who has a child that someone has said is overactive—and during this 15-minute appointment, a perhaps unreliable and therefore questionable test like the Vanderbilt is given to checklist for ADHD. This is just differential diagnosis at its worst. And then the general practitioner says, well, I have to help these children, this family, so we’ll prescribe a stimulant. And perhaps the family go away for three months. And then they come back for another 15-minute visit where this person with no psychiatric training whatsoever asks the family, how’s it going? This is the most unscientific way I could possibly imagine of trying to determine whether the positive and negative side effects of a psychotropic medication are present and to what degree, and therefore if the prescription should continue or not or should change. Psychologists know the whole process. They are capable of doing good assessments, good differential diagnosis. They spend more time with the child and family and can do better follow-up in terms of understanding whether negative side effects are present and if the medication effects, the desired outcomes, are eventuating.

Dr. Sinacola: We have to consider, what could psychologists do differently should they obtain prescription privileges? I think you touched on a very key thing, and that’s better assessment. I think we would all agree that a lot of psychotropics are overly prescribed. Many times we see patients in our practices who had very little assessment done by anyone, and yet they very quickly obtained a prescription from either a psychiatrist or primary care physician. So I think hopefully what will happen is that psychologists will bring that extra piece to the table where they will do a complete assessment before a child is placed on stimulants, or alpha blockers, or anything for ADHD, or medications for depression or psychotic conditions. That’s always been the thing that’s been missing—psychiatry does not assess; they do not test.

Jessica Funk

INSIGHT: Does this come up in your classrooms?

Dr. Konopka: On my first day of classes I ask, who wants to prescribe? It all depends on the composition of
the class. There are some people who are very strong proponents of prescription and very vocal about it and others very reserved. But ultimately by the end of the course, when the question is asked again, more people will raise their hands because they generally feel that they would be more empowered to participate in helping the individual than not.

Dr. Fletcher-Janzen: I spend a great deal of time talking about how school psychologists can help with differential diagnosis and medication management. The obvious point comes up that school psychologists are spending a great deal of time trying to fix what is a broken system at this point. And they would very much like to have more control over what they are doing.

Dr. Sinacola: California requires that all psychologists and MFTs and LCSWs take courses in psychopharmacology.
But what usually comes up is how difficult it is to find a psychiatrist for your patient. That’s often talked about a lot, which has led to us having to develop models for having collaborative relationships with primary care. There are very few students who sit on the fence with this one. They either are for it, or they don’t think it’s for them.

Dr. Pyles: One of the things I thin we also need to get out on the table is that psychosocial interventions and learning-based interventions also change the brain and do it without all the nasty side effects of the more chemical methods. I don’t hear us talking about interventions that change the brain much more safely than do the medications that are prescribed. And our outcome data are at least as good. So, I’m not denying a lot of people have been helped by medication, but I think that the effectiveness has been oversold, and if you look at a lot of who’s doing the research, it’s the drug companies that create the product in the first place, and they have the ability to affect editorial decisions in medical journals because those medical journals also accept advertising from those same drug companies. So I’m not convinced that the information that we’re getting on the results of the drugs’ effectiveness are completely unbiased and don’t need a closer look by a lot of outside objective third parties.

INSIGHT: Any final comments on the issue?

Dr. Konopka: I hope that with time the world of psychology recognizes the importance of participating in the world of medical interventions, and that we begin to engage our students in the process of learning without fear that somehow they are inferior to other disciplines and provide them training so that they can stand on their own two feet with heads up high and be able to say “my opinions are this and this and based on these and these articles that I recently read and so let’s have an argument based on data rather than argument based on impressions.” That’s my hope.

Dr. Sinacola: I think that we should consider training programs to educate those who prefer to be prescribing psychologists to make sure that they are using sound judgment and good research. If it is not happening in the psychology programs, where will it happen?

INSIGHT: Let‘s talk about the psychological impact that this policy has had on servicemen and women, including the 13,000 who have been dishonorably discharged as a result.

Dr. Paul Larson

Dr. Larson: The impact has been to force men and women who are gay or lesbian to lead a double life. When society as a whole has made significant strides in being able to integrate fully our gay and lesbian people, the military has not done so.

Dr. Spaeth: I was active duty Air Force between 1996 to 2000. We were peripherally aware of DADT, but I did have coworkers whom I suspected were really struggling with this policy and keeping quiet about it. And I could see that it looked like they were certainly undergoing the stress of all of that.

When society as a whole has made significant strides in being able to integrate fully our gay and lesbian people, the military has not done so.

Dr. Petroy: I‘ve seen a lot working with online programs throughout my career in academia. I separated from the service in 1992 before DADT actually came about. I was stationed overseas for the majority of the time. Online programs were very popular with military personnel. One student was stationed at my base, and he always achieved the highest reviews. He was discharged for being gay in the military, and he filed a lawsuit against the military. It really impacted his ability to perform as a student or even in life because it changed the dynamics of his expectations and his belief in not only the military, but in the American way.

INSIGHT: Can you talk more about the impact on the transgender population?

Dr. Kerri Rönne

Dr. Rönne: I‘ve known many transgender people with long, eminent military careers. No one ever knew that they were transgender, but I know of several people who have purple hearts and served as Green Berets and were transgender the whole time but living as their biological sex. I know of one young man who, on a whim, joined the military after several years as a cross dresser, and we all thought, ‘Oh my goodness, this can‘t be good.‘ He came back about three months later, and he had been separated. He said that he had taken a dress with him and kept it in his locker hidden under things—a slinky red dress—and at some point, his barrack mates found it. They assumed that he had somehow snuck a woman into the barracks, and he got great acclaim for this; it was like, ‘Yay boy, you go.‘ Eventually this got to superior officers who called him in and, because he was in trouble for that, he said, ‘Well, actually the dress is mine.‘ And they just kind of quietly said, ‘Oh, well, in that case, you can leave. No dishonor, but we‘re just going to separate you.‘

Dr. Petroy: It brings about thoughts about M*A*S*H and watching Klinger.

Dr. Rönne: There are many reasons why transgender people are not allowed to join the military. Many, especially transsexuals, are taking hormones and are considered unfit for duty generally because of the possibility of being in a foreign country where they couldn‘t get their medication, much like being diabetic and insulin dependent would get you out of the military for the same reason. Also many people who are transgender had surgery that may render them looking not exactly like other people. The physical exam requires a genital exam, and if you look abnormal in any way, you‘re not accepted into the military.

Dr. Larson: What has happened since gay liberation is people saying, ‘I want to be who I am and serve at the same time.‘ That‘s what‘s caused the tension that resulted in the DADT policy, which was supposedly a compromise between forces of change and forces of resistance.

Dr. Spaeth: I always heard the rationale that they were afraid of the impact on the morale of a unit. If suddenly there were military members coming out as gay—the fights that it would cause, and if there were prejudicial feelings, it would be those kinds of divisive conflicts that would disrupt the trust and the cohesion of the unit itself.

Dr. Rönne: I think people express fears, some of which are real issues that should be considered and some of which are irrational and mass discrimination. For example, people automatically say, ‘Well, morale will suffer. You‘re going to have men housed together—some are gay, some are straight. They‘ll be sharing bathrooms. This is going to be a disaster.‘ But in reality, any time you go to a health club, you have gay and straight people sharing bathrooms all the time, and how often do you hear of any incident happening that‘s a problem?

Dr. Larson: The argument about unit cohesion was used when we integrated the military with African Americans, and when we brought women into the military. And the solution is not to not do that, but to then provide training and support and leadership to say this is what we‘re doing, and this is why we‘re doing it.

INSIGHT: The Pentagon announced recently that they were changing the policy to make it harder to dishonorably discharge somebody because of sexual orientation. What kind of impact will this latest policy have?

Dr. Larson: I think it‘s significant that the chairman of the Joint Chiefs of Staff indicated that it‘s not if we are going to change, but how we are going to change. That was a very clear signal that the very top leadership of the uniformed military services is fundamentally behind this. Now there are obviously going
to be some people who will voice concerns, but the military is an organization where top down following orders is the culture.

Dr. Anthony Petroy

Dr. Petroy: I am heartened to see senior leadership in the military courageously acknowledging that it‘s the, ‘right thing to do‘. It stands in contrast to what happened when President Clinton tried to open it up completely. There was such a backlash that he put DADT in place as a compromise. Of course, no one was happy with that, and everybody remembers him for putting in place this awful policy. But he did it because he was trying to have it be more open, and it just wasn‘t flying. Now there‘s been an evolution in attitudes and people who have been feeling more empowered to be supportive of that.

INSIGHT: Those of you who were in the military, was there any training around this issue at all?

Dr. Spaeth: It was taboo, actually. If we were told anything about it, it would be to avoid even asking questions remotely close to it in evaluations and assessments.

Dr. Petroy: You didn‘t want to be associated with any dialogue or any discussion around that just because of the fear or the stigma that came along with that. If you were talking about it, either you were associated with it or you knew something, and so they would call you into quarters to discuss it. I was in one of the three installations that had nuclear weapons and we would have 10-day deployments. When you‘re out there with a group of men for 10 days, and you‘re restricted in your interactions with other people… if you‘re discussing that stuff and someone higher up would hear something like that, it would be detrimental to your career.

Dr. Drake Spaeth

Dr. Spaeth: Yeah, I would echo that. There was always the possible threat of demotion if you‘re doing anything that they would disapprove of. It was very rare in the mental health flight for anyone to be given an official order by the head of the mental health clinic who would have to step forward as Lieutenant Colonel Smith as opposed to Dr. Smith. He would have to assume that kind of persona and give you an official order.

INSIGHT: What ethical dilemmas does that set up for mental health professionals?

Dr. Spaeth: There are notorious discussions about the ethical quandaries that active duty military psychologists and mental health professionals face trying to navigate the demands of the APA versus the demands of DOD. One big issue involves informed consent and confidentiality. The fact is in addition to what I like to call the ‘big three‘—danger to self, danger to others, disclosure of child abuse—where we would have to inform clients, we might have to break confidentialityfidentiality. There was a whole list of things that we would have to add to that. If the Office of Security Investigation was investigating some incidents, we would have to make records fully available to them. If their commanding officer would ask for the records, we would have to make those records fully available to them. It always pushed the boundaries of protecting confidentiality as defined by the APA and similar governing bodies. At the same time, the APA supported for the most part the military psychologists position as long as you made APA aware of what your dilemma was every step of the way. In the real sense, the Department of Defense is really who you work for, and that‘s part of the ethical issue there. If you, as a psychologist, feel that the person would benefit from talking about their sexual orientation, you still had to not do that to protect their own interest in remaining employed and remaining in active duty. So there‘s where I think it can potentially become tough.

INSIGHT: Do you have any thoughts about the long-range psychological impact of somebody who has served or who has had to enforce these rules?

There are notorious discussions about the ethical quandaries that active duty military psychologists and mental health professionals face trying to navigate the demands of the APA versus the demands of DOD.

Dr. Larson: I think that those who were discharged because of their sexual orientation will probably have more negative consequences long term, but not by too much from those who just kept a cover all the way through then retired. It would be different. The stigma of being discharged, the lack of veterans‘ benefits that would come with that, are very different than having to live a double life and feeling the tension of needing to hide all the time. Each of those different classes of people will have consequences that are slightly different.

Dr. Rönne: I do know people who have left the military specifically because they wanted to express their gender identity. Oftentimes, as transgender people age, they feel a stronger need to express their true self. So as they get to be middle age, they are just no longer able or willing to hide that any more. They have left long-standing military careers in order to be freer to be who they are.

Dr. Spaeth: It could potentially engender a crisis of identity or selfhood that could go either way. It could be a real positive and empowering movement toward authenticity, or it could potentially be stigmatizing and, again, sharpening the sense of incongruence.

INSIGHT: How do you see your roles as faculty members at a school of psychology dealing with this issue?

Dr. Larson: I stand very much in favor of full and complete integration of people of various gender and sexual orientations into our program, into society, as a whole. I look forward to the time when people who are in the military could be as completely open and well integrated into the communities as the students and faculty who are gay and lesbians here are.

Dr. Spaeth: It‘s important to me also, in terms of teaching diversity to students, that we really tackle that issue and educate students about military culture. Engaging with individuals from that culture is like engaging with individuals from other cultural realities too. I always feel like I‘m in an interesting position as a former active duty member because I‘m both critical of the military on many levels, especially around DADT, but I also feel a loyalty and a defensiveness where the military is concerned.

Dr. Petroy: I think it is critical for us to maintain that integrity of enforcing and working with diversity strongly in the classroom.

Dr. Rönne: We all have a strong duty to deal with issues related to discrimination and stigma in the world in general, and I think the military is part of that. When I teach my course on transgender issues, we talk about the military, but we also talk about many other elements of our society that are unfair and discriminatory to people with gender variance. So I see it as a component of an almost universal problem that is critical for our students to be educated about.

The topic of veterans is an acutely personal one for me. My brother and I followed each other in our tours of duty in Vietnam. Though we both were disabled during our service, Tom, now deceased, suffered far greater harm. My disability was mostly physical, while Tom’s cut to the heart of how he perceived himself as a person, and cast an ever-present shadow over his remaining years. To paraphrase Heraclitus’ famous quotation, one never steps back into the same life following experience in war. That was true of my brother as it is for all veterans before and since.

The television mini-series, The Pacific, chronicling battles of the Pacific theater during World War II, premiered in March on HBO. It was reminiscent of a series aired a decade ago, Band of Brothers, which followed E Company from 1942 to the final days of the war in Europe. The United States was involved in World War II for less than four years, but during the intervening decades, the war has inspired countless books, movies, plays, and retrospectives. It was called the “Good War” by Studs Terkel, while those who lived, fought, and died during that era have been immortalized by Tom Brokaw as “The Greatest Generation.” Depictions of World War II reflect an illusion of clarity and rightness of the cause unmatched in the intervening conflicts.

The title of this essay is taken from a 1973 Time magazine article, published shortly before I was discharged from the Air Force. It begins:

“Veterans of World War II returned to a grateful, generous country that was about to embark on an unprecedented quarter-century of prosperity. Korean War veterans cashed in on much the same rising curve of material benefits. Vietnam vets, by contrast, are the dubious beneficiaries of the nation’s immediate troubled past and uneasy future.

Flash forward: The United States is again engaged in a war on two fronts, Iraq and Afghanistan. Unlike the war portrayed on television, these ongoing wars are more reminiscent of that one fought in the jungles of Southeast Asia. The extended years of conflict and continuous deployments weigh heavily on the lives of military personnel and their families. Further, the frustrations inherent in the indeterminate nature of the “enemy” and the mission creep contribute to the feeling of endless conflict and illusory resolution.

Fortunately, today’s active duty military personnel and veterans are held in higher regard than were my contemporaries four decades ago. Though the term “hero” is cheapened by its profligate use in too many contexts and situations, the heroism and devotion to duty of today’s military is of equal gauge to service personnel at any time in our nation’s history. My fear as I write today is that the nature of contemporary war is grossly misunderstood, and the toll it takes on military personnel and their families remains underappreciated. We are all too easily inured by the media reports of military deaths and disfiguring injuries. We let ourselves become detached and unengaged; in a sense we defer responsibility to others far removed from our comfortable daily lives.

I chose to become a psychologist following my military service in part to give back to my contemporaries, but perhaps more importantly, to learn more about human motivation—my own included—and response to stress. I am optimistic that psychology can contribute in significant and meaningful ways in the intervention and prevention of the causes of societal strife. One small step has come with the inauguration of the first doctoral program of its kind in the world, the Ph.D. program in International Psychology. I believe we have an obligation, as Albee stated many years ago, to give psychology away. To me that means harnessing the power of our discipline and focusing it on the small and the big issues in our society. The world, personal and societal, that Tom and I left to go to Vietnam was neither the same one we stepped back into upon our return to “the world” nor were we the same naïve young men. It is our obligation today to simultaneously address the mental health needs of those involved in conflicts and to work to prevent such future conflicts.

Chicago Campus President Carroll Cradock was quoted in an ABC7 feature about coping with family conflict during the holidays (12/21). She was also quoted—along with Dr. Grant White, associate professor of clinical psychology—in a Chicago Tribune story titled, “Federal Funds Ease Anxiety at South Side Mental Health Agency,” about the federally funded project with the Community Mental Health Council (1/6). Both Cradock and White were quoted in The Chicago Defender’s profile of that initiative as well (1/13).

Dr. Lukasz Konopka, professor of clinical psychology, was quoted in a Chicago Sun-Times story titled “Museum of Science and Industry to Open New Weather Exhibit,” about people’s fascination with weather (3/16).

Dr. Cynthia Langtiw, assistant professor of counseling psychology, was quoted in a Christian Science Monitor website story titled, “After Haiti Earthquake, U.S. Kids Launch Their Own Aid Efforts,” about the psychological effects of the Haiti disaster (1/26).

Dr. Paul Larson, professor of clinical psychology, was featured in an ABC7 story about detecting signs of post-traumatic stress disorder (PTSD) in veterans returning from war by analyzing stress levels in their voices (11/15). He was also interviewed by USA Today for a story titled, “Caregiving Strains Families of Veterans with Severe Injuries,” about Afghan and Iraqi war veterans’ caretakers (1/27).

Dr. Christoph Leonhard, professor of clinical psychology, was quoted in a ChicagoNow and RedEye story titled, “Dare to be Scared,” about people involved in thrill seeking events and haunted houses (10/30).

Dr. Virginia Quiñonez, assistant professor of clinical counseling, was interviewed for a feature story on the Latina Voices website, which focused on her creation and implementation of a culturally competent curriculum that is helping to change Latino mental health services (1/20).

Dr. Melodie Schaefer, executive director of The Chicago School Counseling Centers, bylined the article, “The Best Valentine’s Tips for Singles!,” which was posted on the Single Minded Women website in February.

Dr. Daniela Schreier, assistant professor of clinical counseling, contributed her expertise to several media outlets since our last INSIGHT issue. Among these, she was interviewed by CBS2 for a story about Chicagoans’ knowledge of their politicians (11/03), two stories about Tiger Woods (12/4 and 2/18), and a story about the new French law regarding psychological abuse in relationships (1/6). She was also quoted in the New York Daily News about a new study indicating that women are bigger hypochondriacs than men, but are less likely to die of illness (3/26).

Dr. Debra Warner, associate professor of forensic psychology, now serves as the only psychologist on the Quality Health Medical Advisory Board. Qualityhealth. com is a website that provides articles and information about pressing health matters (12/1).

Dr. Nancy Zarse, associate professor of forensic psychology, was quoted in a Military Spouse website story titled, “The Tragedy of Inaction,” about shared responsibility to our military community and why people fail to intervene in others’ affairs (11/12). She also appeared on the national cable program “E! Investigates: Kidnapping of Jaycee Dugard,” serving as a clinical psychology expert on the case (1/20).

The Chicago School of Professional Psychology and Garfield Park Preparatory Academy were mentioned in a Rockford Register Start website story titled, “Area School Teams up with Academy for Good Cause” (2/1).

The State Journal Register, a Springfield newspaper, mentioned The Chicago School of Professional Psychology in a story titled, “Program Helps Soldiers, Families Return to Daily Life,” and its involvement in the Yellow Ribbon Program (1/16).