“It’s difficult for psychologists to be assertive advocates and then be sabotaged by the very organization that purports to represent them“
Clearly, the last few decades of APA leadership have seen a decline in the practice of professional psychology. Most, if not all, practitioners have seen declines in reimbursement, professional status, and in their patient population. It’s difficult to see anything positive that APA has done for clinicians. From the torture scandal to the fraudulently collection of “mandatory” assessments, the ethics police of our profession have not met the high standards they impose of their membership.
The list of APA successes, if any, is far shorter than their failures. Few, except the disciples of the bureaucratic and bloated APA governance structure, can see any real worth in APA or rationalize the damage they have done to our profession. The eroding membership in APA provides all the proof needed to justify these harsh conclusions.
Yet, for all the scandals, ethical lapses, bloated bureaucracy, and all around neglect of APA’s fiduciaryresponsibility to the membership and profession, they cannot be totally blamed for ruining psychology. Their commitment to their academic and research base, although that membership, too, is declining, has kept the notion of psychology as a “thing” to study.
What APA has ruined, however, are practicing professional psychologists. There was a time when psychologists were real advocates for the profession and for patients. The history of gaining licensure starting in the 1950s by a dedicated and courageous group of twelve psychologists led by Nicholas Cummings and Rogers Wright, gave birth to professional psychology.
This same group, nicknamed “The Dirty Dozen,” and joined by many other advocates, continued to push for reimbursement and the inclusion of clinical psychology into healthcare. While the bureaucrats in APA, who even at that time were obstructionists, were not able to deter the motivation and commitment of these early advocates for our profession.
Although professional psychology has not matched the successes of their advocacy, pockets of that earlier time have popped up at various times breathing some life into the notion that psychologists were still advocates for the things that mattered. Some of the events that come to mind are the “Big Blue” lawsuits in Virginia and elsewhere against insurers who decided it was okay to treat psychologists as second class providers.
In 1989, the lawsuit in California to secure medical staff privileges led by Stephen Berger, is another example ofpsychologists refusing to lie down and accept the status quo. Although many psychologists do not support prescriptive authority, the early proponents of RxP deserve credit and must be included in the historical commitment of psychologists taking on a fight to move the profession forward. However, in all of these struggles, APA either sabotaged many of these efforts or simply engaged in benign neglect.
While some psychologists in state associations have tried to continue our history of strong advocacy, most have succeeded in nothing more than slowing the erosion of the early gains made by the previous generation of advocates. So the issue is: why the decline or even disappearance of psychologists from being assertive advocates to what we see today; a profession of mostly non-committed, low motivated, non-engaged, relatively young group of practitioners?I know that these seem like harsh criticisms, and some are. However,truth can be hard and difficult for some people to process.
The truth is that while APA can be blamed for many things and are clearly responsible for the decline of professional psychology, what they really have achieved is the transformation of the psychologist advocate into the listless and non-engaged, mostly irrelevant practitioner. They have ruined psychologists.
Let’s face it, it’s difficult to be motivated and committed to goals and a profession that is led by an organization that has violated the core principles of the profession, itself. It’s demoralizing when a profession is led by an organization that engages in behaviors that promote the worse images and perceptions of what and who we are.
It’s difficult for psychologists to be assertive advocates and then besabotaged by the very organization that purports to represent them. It’seven more difficult to be motivated for a cause when the organizationthat purports to represent them works against the very interests of their membership.
The latest APA sabotage is the accrediting of master level psychology programs so that their “accredited” professional schools can give credibility to the damage they have done to eroding the doctorate as the entry into independent practice. Note: the doctorate is still required as the entry level into a tenured professorship.There is no master’s level competition for academics and researchers. APA’s accrediting standards will not accredit a psychology program with a faculty comprised of MA level instructors. This amounts to nothing less than hypocrisy in the bureaucracy.
Is It Possible To Resurrect The Advocate Psychologist?
In the eleven years since NAPPP was formed, we have tried to resurrect the advocacy model provided to us by the previous generations of assertive psychologists working on behalf of the profession and patients.
We have advocated for the profession taking on the medical and APA establishments and others who try to diminish or denigrate our role as healthcare providers. Although we are proponents of RxP, we continue, along with the Academy of Medical Psychology, to be the most rational and loudest voice countering the medicalization of mental health.
However, our success has been limited by APA’s continued, slow but sure road to demoralizing psychologists. The vast majority of psychologists who have been turned off by APA havesimply abandoned any attempt to organize and engage in assertive advocacy for the profession.
Belief and Trust Has Been Violated
It should not surprise clinicians who see this same behavior in our patients. When belief and trust is violated in something or someone previously deemed special is consistently experienced, that loss of trust and belief will generalize to others. In the case of psychologists, many simply ignore and vest themselves in their practice and other aspects of their life. All of this is completely understandable and predictable even as it has damaged the profession.
While we must all take responsibility for our failures, including NAPPP, APA must bear the preponderance of blame and even as there is no expectation that they will or even capable of correcting course.
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