Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
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Florida
Psychologist
Publication of the Florida Psychological Association Summer 2018
The Psychological Impact on Immigration
Policies on Migrant Children and Families
See page 10
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TABLE
OF CONTENTS PRESIDENT’s message
Feature Articles By Tim Ketterson, PhD
6 EXECUTIVE DIRECTOR’S MESSAGE
Carolyn Stimel, PhD, ABPP
8 PARKLAND TASK FORCE RELEASES 100
RECOMMENDATIONS
The Associated Press
G
10 THE PSYCHOLOGICAL IMPACT OF reetings FPA Members. Summer is upon us in Florida with
IMMIGRATION POLICIES ON MIGRANT its crushing heat and humidity that are often tempered by
CHILDREN AND FAMILIES
Kristin Hoffman, PhD afternoon storms offering torrents of rain, grumbles of thunder
and jagged bolts of lightning, and occasional tropical systems that send
14 VICARIOUS TRAUMA we mortals scurrying for safety. In organizing my thoughts for this
Juliana Gerena, PsyD; Raven Oshiro, MS;
Adriana Ramirez, MS; Taylor Loftus issue of the Florida Psychologist, I have been struck by the menacing
specters of current social, political, and economic issues clouding our
18 USING MINDFULNESS TO TREAT SMOKING day-to-day lives, perhaps, in a more profoundly unsettling manner than
Michelle Blose, MS
our state’s changeable weather.
20 ACCEPTANCE AND COMMITMENT THERAPY In addition to weather-related natural disasters, communities
Leah Power, PhD around our state have been struck with heartrending loss-of-life from
21 A CAUTIONARY TALE FROM THE BOARD OF mass shootings (Pulse Nightclub on 6/12/2016, Parkland High School
PSYCHOLOGY MEETING on 2/14/2018), and a structural disaster (the FIU bridge collapse on
Carolyn Stimel, PhD, ABPP 3/15/2018). Earlier this month, Florida received a deluge of media
22 POLITICAL COMMITTEE FUNDRAISER attention as part of the unfolding narrative concerning the current
Regina Mendoza, PsyD administration’s policy of separating immigrant children from their
families when suspected of entering the United States illegally.
23 FROM AROUND THE STATE
Diligent and timely advocacy efforts by the American Psychological
24 SOMATIZATION AND SUSTANCE USE Association (APA) and SPTAs from southern border states including
DISORDER Arizona, California, New Mexico, and Texas were instrumental
Michelle Blose, MS
in securing President Trump’s recent Executive Order ending the
25 HELP! I GOT A SUBPOENA! WHAT DOES A policy of separation of immigrant children from their parents. Citing
SUBPOENA DUCES TECUM MEAN? decades of psychological research showing that children separated
Carolyn Stimel, PhD, ABPP
from their parents can suffer severe, clinically-relevant psychological
27 MEMBERSHIP UPDATE distress, APA challenged the administration to reunite the children
Terilee Wunderman, PhD with their families in a timely manner and offered to assist in securing
psychological services for those affected.
28 LAPPB UPDATE
Andy Hicks, PhD In South Florida, the Department of Health and Human
Services (DHHS) operates The Homestead Temporary Shelter for
30 DIVERSITY COMMITTEE UPDATE Unaccompanied Children, an Office of Refugee Resettlement (ORR)
Gary Howell, PsyD
emergency shelter (see https://www.acf.hhs.gov/orr). Services at this
38 TREASURER’S REPORT facility are delivered under contract by Comprehensive Health Services,
Thomas Bonner, PhD, ABPP Inc. of Cape Canaveral FL (DBA Chsi) and can house upwards of
40 FORENSIC ISSUES 1,300 immigrant children. FPA supports APA’s efforts in advocating
Lori Butts, JD, PhD for the psychological welfare of the innocent and disenfranchised
and stands ready to assist in getting these children the psychological
41 MEDICAL PSYCHOLOGY DIVISION
Christopher Rossilli, PsyD, MSCP, MS services they need during the time they are in U.S. custody and upon
their release.
42 NEUROPSYCHOLOGY DIVISION On another solemn note, the recent deaths of two American
Jennifer Katzenstein, PhD, ABPP-CN celebrities (fashion designer, Kate Spade and chef, writer, and
television show host, Anthony Bourdain) by suicide reflect a growing
In Every Issue national crisis according to a recent report released by the Centers for
26 CLASSIFIEDS
29 NEW MEMBERS Disease Control (CDC). The report examined data between 1999 and
44 MEMBER SPOTLIGHT 2016 from the National Violent Death Reporting System, which collects
45 SUSTAINING MEMBERS continued on page 5
46 POLITICAL COMMITTEE CONTRIBUTORS
48 CPE QUIZ - SUMMER 2018 Florida Psychologist • 3
Florida
Psychologist SAVE the DATES
Thursday, July 19, 2018
Grief and Loss: Overview of Current Theory and Practice
Member Editor: Penelope Norton, PhD
Jacksonville, Florida
5:30 to 6:00 Dinner; 6:00 to 8:00 pm CE Presentation
The Florida Psychologist
The Florida Psychologist is the official
publication for the Florida Psychological Friday, July 20, 2018
Association, a professional membership Mindful Eating - Palm Chapter
association for psychologists in Florida. The Florida Boca Raton, Florida • 12:00 pm to 1:00 pm
Psychologist is published four times per year:
Spring, Summer, Fall and Winter. Diagnosing ADHD: The Benefits of Neuropsychological Evaluation
Clearwater, Florida • 12:30 pm. to 2:30 pm
Mission Statement
The mission of the Florida Psychological Friday, August 10, 2018
Association shall be to advance psychology as Trauma Responding Psychologists
a science and profession and as a means of Boynton Beach, Florida • 9:00 am to 12:00 pm
promoting health and human welfare; by the
improvement of the qualifications and usefulness Friday, August 17, 2018
of psychologists through high standards of ethics, Introductory Interdisciplinary Collaborative Practice Training
conduct, education, and achievement; to increase FACP/FPA Co-Sponsor
and diffuse psychological knowledge through Orlando, Florida • 9:00 am to 5:00 pm Daily
meetings, professional contacts, reports, papers,
discussions, and publications; and to advance Wednesday, September 5, 2018
scientific interests and inquiry; and the application Risk Management When Working with Families of Divorce As A Parent
of research findings to the promotion of health and Coordinator - MDMC
the public welfare. Coral Gables, Florida • 7:00 pm to 9:00 pm
Disclaimer
The thoughts, opinions, and positions
expressed in this publication are solely those of
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approval of the advertiser or their service/product
being advertised.
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4 • Summer 2018
2018 FPA BOARD OF DIRECTORS
Message from the President
cont’d from page 3 Executive Committee:
President .............................................................Tim Ketterson, PhD
President Elect ....................................Jessica Vassallo, PhD, ABPP-CN
Immediate Past President ...........................Nekeshia Hammond, PsyD
data from death certificates, coroner and medical examiner reports, and
Secretary ..............................................................Gary Howell, PsyD
law enforcement in 27 states. During this period, suicides increased by
Treasurer ............................................................... Tom Bonner, PhD
25 percent across the United States. An alarming 45,000 Americans
LAPPB Chair ......................................................... Andrew Hicks, PhD
(age 10 or older) died by suicide in 2016 alone. APA has suggested APA Council Representative ........................ David B. Kazar, PhD, ABPP
suicide needs to be a public health priority addressed via a multifaceted FPAGS......................................................................Marilyn Paradoa
public health approach in which we increase access to mental health
screenings and ensure that insurance covers both prevention services Chapter Representatives:
and treatment. Further, the science and practice of psychology play an Bay ................................................................. Kimberly Kinsler, PhD
essential role in both understanding and addressing the biopsychosocial Melina Scally, PsyD
underpinnings of suicide. This crisis affects people both with and Brevard/Indian River ..............................................Helen Barnet, PhD
without diagnosed mental health conditions. Suicide is often an act Broward ............................................................ Craig Fabrikant, PhD
of desperation, brought on by an inability to cope with life’s stressors Laura A. Cohen, PhD
some of which have been termed “Deaths of Despair” in a 2015 report Calusa .................................................................... Kelly Russo, PhD
by economists Anne Case and Angus Deaton in the Proceedings of Capital .................................................................. Craig Asselin, PhD
the National Academy of Sciences. If you or someone you know is Central ...........................................................David J. Romano, PhD
struggling, call the National Suicide Prevention Lifeline at (800) 273- Miami-Dade-Monroe ....................................Terilee Wunderman, PhD
8255 or SMS Text the word “TALK” to 741741 for assistance. Franklin Foote, PhD
As the dog days of Summer give way to the cooler evenings Lower West Coast ..................................................Diane McKay, PsyD
of Fall, several noteworthy events and initiatives will begin to take North Central ............................................................Harry Krop, PhD
shape. In late September 2018, FPA will be hosting a Leadership Northeast .......................................................... Darah Granger, PsyD
Training Retreat in Orlando. We also are entering an active period of Palm ........................................................... Cynthia Silverman, PsyD
planning for the Statewide FPA Conference in 2019, and the Executive Russell Bourne, PhD
Committee will begin to report on lessons learned from the Regional Pinellas ......................................................... Harold Schinitsky, PhD
Conferences pilot. West .................................................................. Ron Yarbrough, PhD
In closing, I thank you for your esteemed collegiality, your
continued support of FPA and daily contributions toward its Mission. COMMITTEE CHAIRS & APA LIAISONS
Disaster Response Network ...............................David J. Romano, PhD
Sincerely, Diversity ...............................................................Gary Howell, PsyD
Tim Continuing Education ............................................David Chesire, PhD
Early Career Psychologist ..........................................Leah Power, PhD
“Hope springs eternal in the human breast…” (Alexander Pope) Elections & Awards ....................................Nekeshia Hammond, PsyD
Ethics Advisory .................................................. Craig Fabrikant, PhD
Federal Advocacy ............................................. Kristi Van Sickle, PsyD
Stephen Bloomfield, EdD
Finance ................................................................. Tom Bonner, PhD
General PAC.................................................... Regina Mendoza, PsyD
Health Care Policy ................................................Michael Smith, PhD
THE FLORIDA SOCIETY Legislative Affairs and Policy................................... Andrew Hicks, PhD
Membership .................................................Terilee Wunderman, PhD
OF CLINICAL HYPNOSIS Prescriptive Authority.................................. Anthony S. Ragusea, PsyD
Public Education Coordinator ...............................Laura A. Cohen, PhD
is offering a 20 CEU hours
Basic Workshop, Fundamentals of Hypnosis With DIVISION PRESIDENTS
Applications, in Orlando, July 20-22, presented by Child, Adolescent and Family .............................. Craig Fabrikant, PhD
FSCH Master Teachers Louis Damis, PhD, ABPP, Forensic Psychology ..........................................Karen Feuerman, PhD
Stephen Warner, PhD, and Larry Goldman, MD. Medical Psychology .................................................Chris Rossilli, PhD
See: www.fsch.org/workshops/basic-workshop, or Neuropsychology ................................................. Lamar Ingulli, PsyD
Women’s Issues .................................................Christina Brown, PhD
call (305) 598-9992.
Florida Psychologist • 5
From the Executive Director
By Carolyn Stimel, PhD, ABPP
Executive Director/Director of Professional Affairs
R
ecently, several volunteer to review all the pending legisla-
groups within FPA have been tive and administrative issues Dr. Karim Yamout has repre-
working on clarifying the role that could affect psychological sented us for several years on the
of professional associations with the practice. Our main lobbyist is state task force that is working on
goal of impressing upon professionals Darricke McGee of the Johnson elder caring issues.
why membership matters. More and Blanton firm. The three of us
than 90% of FPA’s operating budget review the more than 2000 bills Several psychologists have met
comes from member fees and a good that are filed every year for po- with their local legislators seek-
chunk of our activities are done by tential implications for psycholo- ing support for a prescribing psy-
volunteer members who are invested gists. Darricke can meet with chologist bill we plan to file next
in professional development and legislators and their staff when session.
advocacy. Central Office staff has bills are potentially dangerous for
one full time employee (Nickcole us and assist us in promoting the I meet and communicate with
Caldwell) who handles the phones, legislation that is helpful. other mental health association
works on referral requests and does directors on issues such as Tri-
the processing of all the continuing In January, more than twenty care, Blue Cross rates, and the
education credits. Kim Campbell is members from around the state cuts to forensic evaluator rates.
a half-time employee who processes traveled to Tallahassee for two Just today I attended a meet-
memberships, handles the web site, days of legislative training and ing with APA staff and the other
and does our mailings along with our meetings with their local legisla- states’ Directors of Professional
publications. Danielle Humphreys tors at the capitol. FPA provided Affairs to obtain updates on the
returned to us at ten hours a week and travel expenses, meals and hotel issues that every state is dealing
assists the others with their tasks as rooms. with such as further restricting
well as special projects. I am a ¾ time psychologist licenses and trying
employee, keeping the ship afloat. In March five FPA members went to get PsyPact enacted. My par-
One of the non-tangible benefits that to the APA Practice Leadership ticipation in listservs for Execu-
comes from a professional association Conference to attend sessions tive Directors and the Directors
is that of advocacy for the profession. on federal issues and meet with of Professional Affairs allows me
I know that it sometimes seems we our federal legislators at the U.S. to monitor nationwide events for
are in a losing battle in terms of Capitol. This annual trip is done impending threats based on what
protecting the value of our profession. with cost sharing by APA and the other states are handling.
So, what does the advocacy piece FPA. It allowed us the opportuni-
involve? Below, I have outlined some ty to express our concerns about Last year several of us testified
of the activities, particularly over the Tricare to APA staff working on at the legislatively mandated
past year, that staff and volunteers the federal level. task force meetings examining
have been doing, in many cases with telehealth issues. This group
financial support from FPA. Dr. Lori Butts represented FPA generated a report with multiple
at meetings of the legislatively recommendations, including the
FPA pays a lobbyist to monitor mandated Forensic Interview need for third party payers to ad-
and assist with legislative issues. Task Force which is finalizing equately reimburse such services.
The lobbyist, Legislative Chair their report on recommended best Unfortunately, none of these were
Dr. Andy Hicks and myself have practices for forensic interview- considered in the 2018 legislative
meetings every few weeks (and ing of child victims of abuse and session.
weekly during the two-month violence. FPA takes care of travel
legislative session) to review expenses whenever we are on a The North Central chapter in
pending issues. This allows us task force. Gainesville had a successful town
6 • Summer 2018
2019 FPA Conference survey
Q1 I would _____ attend a statewide FPA Conference.
Answered: 225 Skipped: 0
Not
Probably Not
Probably
Definitely
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ANSWER CHOICES RESPONSES
Not 2.22% 5
Probably Not 17.78% 40
Probably 63.11% 142
Definitely 17.78% 40
Total Respondents: 225
hall meeting to talk about current sent FPA when they occur in their I hope that this gives you and idea
concerns. The Bay chapter in area. of the range of advocacy activities
Tampa held a well-attended meet that FPA works on as we monitor and
and greet for mental health pro- Our Federal Advocacy Coordina- influence decision making in a variety
fessionals as well as other service tors (Drs. Stephen Bloomfield of areas around the state. If you ever
providers in their area. Events and Kristi VanSickle) work with have any questions, reach me at
like these introduce psychologists APA to advocate and disseminate carolyn@flapsych.com.
to other professionals and put the Action Alerts on the national
our profession forward. FPA sup- level. Survey Results
ports all the chapter activities and I was quite pleased that 225 FPA
needed funds for those. FPA works closely with the members responded to our questions
governing board of the Political for the 2019 convention we are
Five days a week I review admin- Committee (PAC) to make deci- planning (see results above). We are
istrative rule changes made by sions about the use of campaign shooting for some time in September.
multiple state agencies in order contributions. I function as the Take a look at the results. They are
to monitor potential changes that treasurer for those funds and fairly clear and self-explanatory.
might affect psychological prac- several FPA leaders serve on that Thanks to all of you; it really helps in
1/7
tice. I also review every Board board. the planning efforts!
of Psychology meeting either in I consult with members all the
person or afterwards via audio in time on how to report other pro-
order to monitor their actions. In fessionals who misrepresent their
addition, a number of our mem- credentials or operate outside
bers attend the meetings to repre- their scope of practice.
Florida Psychologist • 7
Parkland Task Force Releases
100 Recommendations
By The Associated Press
A
task force keeping classroom
has released doors locked at all times
a report with and installing cameras
100 recommendations to monitor every inch of
for keeping kids safe in school grounds.
the wake of the Florida The task force says
school shooting that schools should evalu-
killed 17. ate whether student
The Broward Coun- discipline measures are
ty task force released being enforced consis-
the report Monday but tently and re-examine a
noted it will be difficult diversion program de-
to fund the measures, signed to keep students
which include hiring out of the school-to-
additional school coun- prison pipeline. Nikolas
selors, therapists and Cruz, the suspect in
school police officers The task force also recommends the Parkland shooting,
and hardening schools with metal random searches at schools, raising had been referred to the program in
detectors and window coverings. the heights of fences around schools, middle school but did not complete it.
CAREER CENTER
Whether you’re looking for a job or looking for a job applicant, the career center has something for everyone.
• Reach highly qualified job seekers involved in the psychological industry
• Save time by easily managing and tracking all your applicants right from the FPA Career Center. Set up resume
alerts and receive automatic emails when an applicant meets job posting criteria.
8 • Summer 2018
Florida Psychologist • 9
FEATURE
The Psychological Impact of Immigration
Policies on Migrant Children and Families
By Kristin Hoffman, PhD
Director, Trauma Psychology, Johns Hopkins All Children’s Hospital
B
y now, most, posttraumatic stress
if not all of (Trickey et al., 2012).
us, have heard Similarly important
about the Trump Ad- are the reactions of
ministration’s “Zero- the child’s caregivers
Tolerance” policy that during and following a
involved separating im- trauma. A stable, sup-
migrant children from portive caregiver who
their parents detained at is available to help a
the U.S.-Mexico border child feel safe and cope
and then subsequent in effective ways is one
executive order end- of the most important
ing this practice. While protective factors and
this policy reversal predictors of positive
may protect future im- adjustment following
migrants from family a traumatic experience
separations, many ques- (Bonanno & Diminich,
tions remain about the 2013).
order and upcoming immigration legislation. For instance, It is essential to consider the past and current experi-
what is the plan for reuniting the 2,000 plus families who ences of U.S. immigrants and refugees in light of this
have been separated? Now that families will be detained research. Data from the Migration Policy Institute (Rosen-
together, where will they be housed and what type of treat- blum & Ball, 2016) indicate a dramatic increase in arrivals
ment will they receive? What are the potential conse- of undocumented children from Guatemala, Honduras, and
quences of family separation and detention on the mental El Salvador beginning in 2014, which corresponds with
health and well-being of migrant families? Over the past the escalation of violence and poverty in these countries.
few years, immigration has become a focus of American In a 2013 study conducted by the United Nations High
politics, with many divided over the impact of immigra- Commissioner for Refugees (U.N. Refugee Agency, 2014),
tion on our country and the best way to address it through 58% of the approximately 400 unaccompanied minors in
legislation. During times of divisive political policies and the U.S. that were surveyed reported they had suffered
rhetoric, it is important for us as psychologists to look or been threatened with serious harm that was sufficient
beyond our political views to what science is saying about enough to merit protection under international law. The
the impact of policy decisions on children and families. trauma and violence that causes many families to flee
their countries may follow them during their journey to
Trauma and Stress among Immigrant Families the U.S., where conditions are often dangerous and over-
Decades of research have taught us that separating crowded. Due to their histories of repeated and chronic
children from their caregivers is stressful and potentially trauma, children from immigrant families seeking asy-
traumatic and that how children react to stress is depen- lum in our country are a vulnerable population. Abruptly
dent upon a number of factors. Delayed development, separating children from their parents at a time when they
lower socioeconomic status, prior experiences of adversity need their parents’ love and protection the most puts them
and trauma, and closer proximity to a traumatic event are at significant risk for further emotional and behavioral
crucial factors that increase a child’s risk for developing distress.
10 • Summer 2018Although we do not yet know the direct impact of difficulty adjusting to a new culture which they view as
the recent parent-child separations at the border, and very harsh or unjust. In addition, many of their parents may
limited research is available regarding family detention have physical and/or psychological difficulties related to
experiences in the U.S., we can extrapolate data from other chronic adversity and trauma experienced prior to, during,
studies. Literature in the area of child welfare indicates and after their journey to the U.S. These mental health dif-
that sudden parent-child separations can be traumatic ficulties, in addition to the limitations posed by detention,
for some children. Research on immigrant children and may disrupt parents’ ability to provide safe and enriching
refugees show high rates of PTSD, anxiety, depression, environments for their children that promote resilience.
suicidal ideation, withdrawal, attention difficulties, and
sleep disturbances in this population (Fazel & Stein, 2002). What Psychologists Can Do
The American Psychological Association’s Division 27 While many of us will not provide direct services to
(Society for Community Research and Action, 2016) has immigrant children and families while they are being de-
stated that the detention of families in prison-like settings tained, all of us are in a position to advocate for vulnerable
while they await deportation hearings can cause psycho- populations who are in the care of the U.S. As psycholo-
logical trauma and have long-lasting effects on children’s gists, we have the unique opportunity to call attention to
physical, cognitive, and psychological development. Given the long-term psychologi-
these concerns, The American Academy of Pediatrics cal impact of our country’s
released a Policy Statement on the Detention of Immigrant treatment of immigrants
Florida is one of
Children noting that “there is no evidence indicating that and to endorse govern- the top 5 states in
any time in detention is safe for children.” (Linton, Griffin, mental policies that are in
Shapiro, & AAP Council on Community Pediatrics, 2017, the best interests of chil-
the U.S. with the
p. 6). dren and families. Major largest popula-
Discoveries from the fields of neuroscience and epi- professional organizations,
genetics show us that both genes and experiences shape the including the American tions of children
structure and function of the developing brains of children. Psychological Association of unauthorized
Prolonged exposure to stress and adversity can produce and the American Acad-
excessive activation of stress hormones like cortisol and emy of Pediatrics have immigrants (Mi-
adrenaline, which disrupt brain development and the
functioning of other systems (e.g., immune, cardiovascu-
spoken out against prior gration Policy
immigration policies and
lar, etc.) over time. When children are in a constant state their potential to create Institute, 2018),
of stress or threat, internal resources are diverted away
from such things as reaching developmental milestones to
a mental health crisis for
immigrant families. They
making it im-
ensuring their immediate survival. Toxic stress responses have also called for the portant for us to
create weak foundations for learning, behavior, and health thousands of children and
and can cause permanent changes in the brain (Shonkoff et families currently being
understand the
al., 2012). Children who are exposed to chronic adversity detained and/or await- needs and expe-
and stress are at heightened risk of lifelong mental health ing immigration hearings
problems, addictions, heart disease, and diabetes. to receive health, dental,
riences of these
Even in the face of toxic stress, the brain has incred- and mental healthcare that families.
ible plasticity and potential for growth. Healthy brain meets guideline-based
development in children requires safe, stable, and con- standards and mitigates
sistent environments, which are most often provided by harm or re-traumatization (Linton et al., 2017).
supportive caregivers. Returning immigrant children to Florida is one of the top 5 states in the U.S. with the
their parents is a step in the right direction to improve their largest populations of children of unauthorized immigrants
well-being, but is not sufficient by itself to restore children (Migration Policy Institute, 2018), making it important
to healthy levels of functioning. Although children may for us to understand the needs and experiences of these
be physically safe when reunited with their parents, it is families. When providing services to this population, it is
important to recognize that stress has left a lasting impact crucial that we not only work to understand and respect
on their developing brains and that children may not feel their cultural values, language, and acculturation, but that
psychologically safe. They are likely worried about what
will happen to them and their families next and may have continued on next page
Florida Psychologist • 11The Psychological Impact on Immigration Policies cont’d from page 11
we utilize a trauma-informed approach to their care that resources/mental-health-interventions-refugee-children-
includes the following: 1) acknowledging the impact of resettlement-white-paper-ii
trauma in their lives, 2) assessing for signs and symptoms
of trauma and considering how trauma may be contribut- APA’s Multicultural Guidelines: http://www.apa.org/about/
ing to a child or family’s emotional and behavioral pre- policy/multicultural-guidelines.aspx
sentation, 3) integrating knowledge of trauma into the
system of care, and 4) resisting re-traumatization through References
the principles of safety, trustworthiness, choice, collabora- Bonanno, G.A., & Diminich, E.D. (2013). Annual research
tion, and empowerment (SAMHSA, 2014). Additionally, review: Positive adjustment to adversity – trajectories of
in order to provide the most effective interventions for minimal-impact resilience and emergent resilience. Jour-
immigrant families, we must also learn about their current nal of Child Psychology and Psychiatry, 54(4), 378-401.
acculturative and resettlement experiences, possible anxi- doi:10.1111/jcpp.12021
eties related to deportation, experiences of discrimination,
barriers to care (e.g., limited healthcare coverage, transpor- Fazel, M. & Stein, A. (2002). The mental health of refugee
tation issues, stigma, mistrust of systems, etc.), and unique children. Archives of Disease in Childhood, 87, 366-370.
strengths and protective factors. And lastly, what we as doi:10.1136/adc.87.5.366
mental health providers need to believe in and communi-
cate to families is hope – hope that through providing them Linton, J.M., Griffin, M., Shapiro, A.J., & AAP Council
with evidence-based practices, linkage to resources, and on Community Pediatrics (2017). Detention of immigrant
culturally competent care that we can improve their health, children. Pediatrics, 139(5), 1-13. doi:10.1542/peds.2017-
well-being, and ability to cope with stress. 0483
Resources for Working with Immigrant Rosenblum, M., & Ball, I. (2016). Trends in Unaccompa-
Families nied Child and Family Migration from Central America.
NCTSN Refugee Services Core Stressor Assessment Tool: Washington, DC: Migration Policy Institute. Retrieved
https://learn.nctsn.org/enrol/index.php?id=62 from https://www.migrationpolicy.org/research/trends-un-
accompanied-child-and-family-migration-central-america
APA’s Cultural Formulation Interview: https://www.psy-
chiatry.org Shonkoff, J.P., Garner, A.S., & The Committee on Psycho-
social Aspects of Child and Family Health (2012). Techni-
NCTSN Resource on Mental Health Interventions for cal report: The lifelong effects of early childhood adversity
Refugee Children in Resettlement: https://www.nctsn.org/ and toxic stress. Pediatrics, 129(1), 232-246. doi: 10.1542/
peds.2011-2663
Society for Community Research and Action (2016).
Policy statement on the incarceration of undocumented
migrant families. American Journal of Community Psy-
chology, 57, 255-263. doi:10.1002/ajcp.12017
Trickey, D., Siddaway, A.P., Meiser-Stedman, R., Serpell,
L., & Field, A.P. (2012). A meta-analysis of risk factors for
post-traumatic stress disorder in children and adolescents,
32 (2), 122-138. doi:10.1016/j.cpr.2011.12.001
U.N. Refugee Agency. (2014). Children on the Run,
Unaccompanied Children Leaving Central America and
Mexico and the Need for International Protection. Wash-
ington, DC: U.N. Refugee Agency. Retrieved from www.
unhcr.org/en-us/children-on-the-run.html.
12 • Summer 2018RxP Designation Committee Call for Nominations
The American Psychological Association (APA) Board of Education Affairs (BEA) and the Committee for
the Advancement of Professional Practice (CAPP) are seeking nominations to fill two seats on the
Designation Committee for Postdoctoral Education and Training Programs in Psychopharmacology for
Prescriptive Authority (RxP Designation Committee). The appointees will serve a three-year term
beginning Jan. 1, 2018. Committee members shall meet once a year in the fall and may work, as needed,
throughout the year via email and conference calls. The primary task of the committee is to review
applications from training programs in psychopharmacology seeking to be designated by the APA.
The deadline for all nominations is Monday, August 6, 2018. If you are interested in serving on the
committee, or know of someone else who would be qualified for this position, please send nominations,
along with the below-described information, to Kristyn Dempsey. Please note that nominators of other
individuals are responsible for ensuring that these materials are submitted.
Candidate Criteria
We welcome nominations of individuals who have expertise in any of the following domains:
• Psychopharmacology postdoctoral program directors.
• Basic psychopharmacology science or clinical psychopharmacology research.
• Prescriptive authority in psychology.
• Prescriptive authority in another health care profession.
• Health care system quality assurance.
Other areas of interest are developmental psychopharmacology, integrated health care systems, and
ethnic/cultural factors that can influence psychopharmacological decision-making. The RxP Designation
Committee is composed of one public member seat (currently occupied) and five member seats
comprised of psychologists who are APA members. The committee especially welcomes early career
psychologists (psychologists who are within 10 years of the receipt of their doctoral degree) who
otherwise meet the categories noted above. Appointments to the committee are made jointly by BEA
and CAPP, and confirmed by the APA Board of Directors. Those appointed to the committee will be
notified in writing.
Nominees, if appointed, agree to dedicate the time necessary to fulfill their responsibility to the
committee including but not limited to work between meetings, reviewing documents and applications,
responding to requests from APA staff in a timely manner, and attendance at all meetings.
Candidate Submission Materials
• Letter indicating the individual’s willingness to serve if selected.
• 300-word description of qualifications as relates to the areas of expertise noted above.
• If applicable, indication that they qualify as an early career psychologist (ECP), as defined above.
• Current curriculum vita.
Florida Psychologist • 13Vicarious Trauma: Making Meaning of Trauma and
the Helping Professional
By Juliana Gerena, PsyD; Raven Oshiro, MS; Adriana Ramirez, MS and Taylor Loftus
D What is Vicarious Trauma?
uring the last decade, mental cal and sensory changes, which are
health professionals have A challenge often arises when symptoms associated with Post-Trau-
devoted increasing attention attempting to derive one specific matic Stress Disorder (PTSD). As a
to the negative impact of working definition for Vicarious Trauma (VT). result, these experiences may cause
with traumatized individuals. When Although VT occurs in multiple set- significant changes in affect, such as
providing mental health services to tings across the world, the definition depression and irritability, which can
individuals, the helping profes- impact the individual’s daily life
sional engages in therapeutic interactions as well as impede their
encounters, which can result in therapeutic work with clients.
them being indirectly exposed Molnar et al. (2017) used the
to a myriad of stressful events. term Secondary Trauma Stress
Helping professionals aim to (STS) synonymously with VT. The
establish a therapeutic alliance authors stated even without direct
with their clients by express- exposure to a traumatic event,
ing empathic bonding, utilizing helping professionals working
listening skills, and exhibiting with traumatized individuals may
unconditional positive regard. exhibit symptoms almost identical
Throughout this process, help- to those of PTSD, such as intrusive,
ing professionals are exposed to can fluctuate, and other descriptions avoidance, arousal, and emotional
their client’s trauma, resulting in are used interchangeably. The term impairment symptoms. Therefore,
cognitive, emotional, and behavioral VT was first introduced in the 1990’s one person’s exposure to trauma
changes for clinicians working with by Pearlman and colleagues who becomes a traumatic event for the
victims of a trauma (Craig & Sprang, described it as the change that occurs second person involved. Another term
2010). Thus, the long-lasting expo- within the helping professional due used in the literature to describe the
sure to the distress from the clients to their empathic engagement when negative impact of trauma-focused
who have suffered traumatic events hearing their client’s narration of a work, especially among clinicians,
can lead to the helping professional traumatic event (Sansbury, Graves, is Compassion Fatigue (CF). Figley
becoming emotionally drained and & Scott, 2014). This change includes (1995) described CF as a gradual
burned-out. The literature comprises cognitive dysfunctions such as dis- lessening of compassion over time,
various terms which have been used torted memories, the development of resulting in the clinician no longer be-
to describe the stress resulting from cognitive avoidance, and generaliza- ing able to provide adequate services
working with a person who has been tions of negative feelings (Sansbury to the intended population.
exposed to a traumatic experience et al., 2014). Therefore, when helping
including, Vicarious Trauma (VT), professionals are exposed to VT it is Prevalence of Vicarious
Secondary Traumatic Stress (STS), likely they will respond by detaching Trauma
and Compassion Fatigue (CF) (Pearl- themselves from the situation and or Prevalence of VT, STS, and CF
man & Saakvitne, 1995; Schauben & by distrusting others. Professionals has been studied more extensively
Frazier, 1995). who are exposed to VT are at risk among professionals who work with
of developing negative psychologi- survivors of trauma, including those
14 • Summer 2018who provide services to victims of of self-assessment, mental health may also be a reasonable treatment
a sexual assault, domestic violence professionals should pay attention option, particularly for those help-
victims, child or adult protective to warning signs including difficul- ing professionals with their own past
services, and advocacy centers within ties concentrating during sessions, trauma history (Newell & MacNeil,
the legal system (Molnar et al., 2017). hostility toward clients, cancelling 2010). Behavioral strategies, such as
Among these populations the preva- or missing sessions with clients, and maintaining physical health, bal-
lence of CF and other related condi- difficulties sleeping (Bamonti et al., anced nutrition, receiving adequate
tions fluctuates across areas of exper- 2014). Professionals should strive sleep, exercise, or recreation, could
tise (Miller & Sprang, 2017). Various to complete self-assessments of also serve to buffer the effects of VT
studies have found that 8% to 16% their emotional wellness and remain (Newell & MacNeil, 2010).
of graduate students and social works cognizant of evidence of posttrau-
reported experiencing CF (Adams & matic symptoms as it is essential to Impact on Practice and Ethics
Riggs, 2008; Bride, 2007). Whereas recognize the importance of engaging The American Psychological As-
other studies found 50% of clinicians in self-practice behaviors (Johnson et sociation (APA) Ethical Principles of
treating trauma survivors reported al., 2014). Psychologists and Code of Conduct
experiencing CF (Bride, Jones, & Self-care strategies for helping (hereinafter referred to as the Ethics
MacMaster, 2007; Conrad & Kellar- professionals include setting realistic Code) states that psychologists are
Guenther, 2006; Hargrave, Scott, & goals to manage their workload and exclusively responsible for ensuring
McDowall, 2006). Similarly, studies client care, utilizing coffee and lunch competence to provide therapeutic
on STS in different fields identified breaks, receiving adequate rest and services. Specifically, the General
clinical psychologists who work with relaxation, and maintaining positive Principles of the Ethics Code reminds
traumatized individuals to have ex- connections with close friends and psychologists “to be aware of the pos-
perienced higher levels of STS when family (Newell & MacNeil, 2010). In sible effect of their own physical and
compared with other mental health addition to these self-care practices, mental health on their ability to help
professionals (Kadambi, & Truscott, receiving support from professional those with whom they work” (APA,
2008). The literature on STS has also colleagues and supervisors may also 2017). The Ethics Code highlights
focused on identifying the severity serve to decrease the effects of pro- the importance of psychologists tak-
levels associated with the profession- fessional burnout (Newell & Mac- ing reasonable steps to protect their
al’s response to their client’s trauma Neil, 2010). Considering that burnout clients when presented with personal
(Elwood, Mott, Lohr, & Galovski, can result from exposure of extreme problems, as these instances can
2011). Specifically, clinicians who cases, it is important to ensure clini- pose a risk of impacting the profes-
work primarily with traumatized cians, supervisors, and supporting sionals’ competence. Specifically,
individuals experience higher levels agencies work collaboratively to psychologists who work in hazardous
of STS as compared to other mental identify symptoms of VT (Sansbury, or life-threatening settings may be
health professionals (Kadambi & Graves & Scott, 2014). Specifically, at significant risk for experiencing
Truscott, 2008; Birck, 2001). engaging in peer consultation and trauma-related symptoms, which can
discussing cases with supervisors can impede their professional competence
How Can Professionals provide emotional and social sup- (Johnson et al., 2014). McCormack
Manage Exposure to VT? port as well as normalize the experi- and Adams (2016) examined the
It is essential to have professional ence for the clinician (Johnson et al., psychological effects for therapists
awareness of preventive measures 2014). For example, clinicians may working with complex trauma in an
that can be used individually and benefit from participating in regularly inpatient setting. Professionals who
within the work place to prevent VT. scheduled professional development participated in this study identified
Newell and MacNeil (2010) defined activities to enhance competencies their personal distress, fatigue, and
professional self-care as the utiliza- (Newell & MacNeil, 2010). Other self-doubt to have impacted their
tion of skills and strategies by work- recommendations include engaging diagnostic approach and professional
ers to maintain their own personal, with colleagues outside of the work integrity. In addition, participants
familial, emotional, and spiritual environment to enhance self-aware- reported experiencing difficulties
needs while attending to the needs ness and strengthen social support maintaining empathy and managing
and demands of their clients. In terms (Johnson et al., 2014). Psychotherapy continued on next page
Florida Psychologist • 15Vicarious Trauma: Making Meaning of Trauma cont’d from page 15
their facial expressions when com- References Kadambi, M. A., & Truscott, D.
pleting sessions with their patients Adams, S. A., & Riggs, S. A. (2008). (2008). Traumatizing aspects of
(McCormack & Adams, 2016). Thus, An exploratory study of vicarious providing counselling in commu-
highlighting the importance of sup- trauma among therapist trainees. nity agencies to survivors of sexual
porting the ethical obligation to com- Training and Education in Profes- violence: A concept map. Canadian
plete self-assessments and self-care sional Psychology, 2(1), 26-34. Journal of Counselling & Psycho-
practices among psychologists. doi:10.1037/1931-3918.2.1.26 therapy/Revue, 42, 192–208.
The importance of establishing
self-care practices while working in Bamonti, P. M., Keelan, C. M., Lar- Miller, B., & Sprang, G. (2017).
the mental health field has become son, N., Mentrikoski, J. M., Randall, A components-based practice and
increasingly recognized, however, C. L., Sly, S. K., & ...McNeil, D. W. supervision model for reducing com-
there is limited research on identify- (2014). Promoting ethical behavior passion fatigue by affecting clinician
ing the importance of self-care prac- by cultivating a culture of self-care experience. Traumatology, 23(2), 153
tices among psychologist (Bamonti during graduate training: A call to 164. doi:10.1037/trm0000058
et al., 2014). Although research has action. Training and Education in
identified graduate students to report Professional Psychology, 8(4), 253- Molnar, B. E., Sprang, G., Killian, K.
experiencing high levels of distress, 260. doi:10.1037/tep0000056 D., Gottfried, R., Emery, V., & Bride,
a greater emphasis should be placed B. E. (2017). Advancing science and
on employing self-care practices Craig, C. D., & Sprang, G. (2010). practice for vicarious traumatization/
among psychology and mental health Compassion satisfaction, compassion secondary traumatic stress: A research
graduate training programs (Bamonti fatigue, and burnout in a national agenda. Traumatology, 23(2), 129-
et al., 2014). By promoting a culture sample of trauma treatment therapists. 142. doi:10.1037/trm0000122
of self-care practices for profession- Anxiety, Stress & Coping: An Inter-
als early in their career, it may help national Journal, 23(3), 319-339. Newell, J. M., & MacNeil, G. A.
future mental health professionals es- doi:10.1080/10615800903085818 (2010). Professional Burnout, Vicari-
tablish healthy behaviors, which may ous Trauma, Secondary Traumatic
foster wellness and reduce the risk of Figley, C.R. (1995). Compassion Stress, and Compassion Fatigue: A
impairment in the future. Psychology fatigue as secondary traumatic stress Review of Theoretical Terms, Risk
training programs and practicum sites disorder: An overview. In C.R. Figley Factors, and Preventive Methods
(Ed.), Compassion fatigue: Coping for Clinicians and Researchers. Best
should encourage students to engage
with secondary traumatic stress dis- Practice In Mental Health, 6(2), 57-
in self-care behaviors and to regularly
order in those who treat the trauma- 68.
monitor their own physical, mental,
and emotional wellbeing. In addi- tized (pp. 1-20). New York: Brunner/
Mazel. Pearlman, L.A., & Saakvitne, K.W.
tion, Bamonti and colleagues (2014)
(1995). Trauma and the therapist:
proposed that the APA should clearly
Harrison, R. L., & Westwood, M. J. Countertransference andvicarious
define self-care as part of the train-
(2009). Preventing vicarious trauma- traumatization in psychotherapy with
ing process for graduate programs to
tization of mental health therapists: incest survivors. New York: W.W.
enhance performance among train-
Identifying protective practices. Norton.
ees. Finally, from an ethical point of
Psychotherapy: Theory, Research,
view, self-care practices should not Sansbury, B. S., Graves, K., & Scott,
Practice, Training, 46(2), 203-219.
be implemented only in the event of W. (2015). Managing traumatic stress
doi:10.1037/a0016081
distress or impairment. It is important responses among clinicians: Indi-
to understand that self-care practices vidual and organizational tools for
Johnson, W. B., Bertschinger, M.,
are necessary not only for those who self-care. Trauma, 17(2), 114-122.
Snell, A. K., & Wilson, A. (2014).
are having difficulty managing the Secondary trauma and ethical obli- doi:10.1177/1460408614551978
demands of training and working in gations for military psychologists:
the mental health fields, but continual Preserving compassion and com- Schauben, L.J., & Frazier, P.A.
self-care practices are critical for the petence in the crucible of combat. (1995). The effects on female coun-
promotion of wellbeing. Psychological Services, 11(1), 68-74. selors of working with sexual
doi:10.1037/a0033913 violence survivors. Psychology of
Women Quarterly, 19, 49-64.
16 • Summer 2018Florida Psychological Association
Call for Nominations
Rules:
1. You may nominate only one (1) person for each office. Self‐nominations are acceptable.
2. A nominee must receive ten (10) nominations in order to be listed on the final ballot.
3. Only Regular, Federal, Active‐Duty Military, Semi‐Retired, Senior Psychologist and Retired FPA
members in good standing as of July 1, 2018 may run for office or submit nominations. Associate, out‐of‐
state, affiliate and student members are not eligible.
4. You may only submit one nomination form ‐ subsequent forms shall not be counted.
5. Nominations must be received by Friday, August 3, 2018 at 5:00 pm EDT to be counted.
6. To be eligible for nomination as an FPA officer at the state level, the nominee must have held a
leadership position in a division, special interest group, or chapter as an officer, chapter representative to
the Board of Directors, or member of a FPA chapter or state‐level standing board or committee for no less
than one year.
Nominations must be received by Friday, August 3, 2018 at 5:00pm EDT.
I wish to nominate the following individual(s) for FPA office:
FPA President‐Elect, President‐elect term commences January 1, 2019; Presidency in 2020;
and Immediate Past President in 2021.
Name of Nominee:
FPA Treasurer, 2‐year term. Term commences in January 1, 2019 and expires December 31,
2020.
Name of Nominee:
Nominated by:
(Required – Print legibly or type. If we cannot read your name the nomination will not count.)
Your Signature: ______________________________________________________
(Required ‐ The form will not be counted without a signature.)
Received no later than Friday, August 3 at 5:00pm EDT.
MAIL or FAX to: FPA Nominations
408 Office Plaza Drive
Tallahassee, FL 32301
FAX: 1 (850) 344‐9085
Email to: carolyn@flapsych.com
Florida Psychologist • 17Using Mindfulness to Treat Smoking:
The iPhone/iPad Application
By Michelle Blose, MS, Nova Southeastern University, Bay Pines VAHCS Neuropsychology Intern
Smoking: What’s the Issue? cessation. Mindfulness Training treatment. Additionally, MT may be
Smoking causes heart disease, (MT) has begun to show benefits in effective as a treatment for smoking
cancer, respiratory illness, and other a number of psychiatric disorders, cessation and informal mindfulness
medical conditions (Fichtenberg including depression, anxiety and practice predicts a decoupling of
and Glantz, 2002). In 2010, 20.2% more recently, in addictions (Brewer the association between craving and
of adults in the United States were smoking (Elwafi et al., 2013).
current smokers and 25.2% used any For smoking cessation,
tobacco product, such as smokeless mindfulness may help one manage
tobacco, water pipes, or cigarillos nicotine cravings or feelings of
(Ablah, Dong, & Konda). Tobacco withdrawal when quitting smoking;
use continues to be the leading cause reduce stress, anxiety, and depression;
of preventable death in the United increase positive emotions and
States. While numerous individuals enjoyment in daily life; encourage
do not smoke, at least 53,000 non- healthier eating habits; and improve
smokers die each year due to second relationships. “MT may help
and third hand smoke. Third hand individuals learn to ‘sit with’ negative
smoke refers to the chemicals in effects, cravings, and withdrawal
cigarette smoke that settle on the without habitually reacting to these
surfaces inside a home or on clothing unpleasant states by smoking”
(Burton, 2009). In brief, this means, (Brewer et al., 2011).
that for approximately every eight et al., 2011). Brewer and colleagues
smokers, one non-smoker dies. (2011) found that their initial trial The iPhone and iPad
Mainstay behavioral treatments for of MT may confer benefits greater Application
smoking have focused primarily than those associated with current The Craving to Quit! iPhone
on “teaching individuals to avoid standard treatments for smoking application is a three-week self-
cues, foster positive affective states, cessation. Moreover, treatments that directed program available for both
develop lifestyle changes that reduce target both affective states as well as iPhone and iPad that incorporates
stress (e.g., practice relaxation), cravings, may be helpful in smoking research on mindfulness training. The
divert attention from cravings, cessation (i.e., MT). “Mindfulness application was created by Dr. Judson
substitute other activities for approaches have been operationalized Brewer, former medical director
smoking, learn cognitive strategies to include two components: (1) at Yale Therapeutic Neuroscience
that reduce negative mood, and maintaining attention on the Clinic. Every day, with the
develop social support mechanisms” individual’s immediate experience application, the individual states how
(Brewer et al., 2011, p. 2). and (2) maintaining an attitude of many cigarettes he or she smoked.
acceptance toward this experience” Also, there is a “Want-O-Meter” on
Use of Mindfulness Training (Bishop et al., 2004). Those who the application where the individual
have received mindfulness training
for Tobacco Use states how badly he or she wants a
have shown a greater reduction cigarette and then what triggered
It is believed that mindfulness
rate in smoking, which lasts over the craving. It then gives different
is a potential moderator to smoking
18 • Summer 2018You can also read
