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Hello ACPA! I hope that each of you are doing well. Since the last edition of this newsletter, a lot has changed in our lives. COVID-19 has had a huge impact upon us, upon the world, and upon the profession of psychology. Many of you have begun providing therapy sessions exclusively via telehealth. For those of you who work in agencies or who teach/supervise, you have had to quickly adapt to new ways of doing things. Some of you have lost clients and business, especially those of you that conduct psychological assessments. Suffice it to say that this is a challenging time. As President of ACPA, I want to let you each know that ACPA is here for you and that the ACPA Board desires to support each of you to the best of our abilities. In times like this, I’m of the opinion that membership in professional associations is of the utmost importance; many members have been receiving support from each other through our listserve about how to make the shift to telehealth, to understand changes to insurance reimbursement policies, and to discuss the clinical implications of COVID-19. I have taken it upon myself to forward announcements from CPA and APA with information about how psychology is changing as a result of COVID-19. I also want to remind everyone that our Ethics/Professional Affairs Chair, Dr. Kelley Gin, is available for ethical/legal consultations on these, as well as other, issues. Furthermore, ACPA is doing what we can to support our members and to be of service to frontline healthcare workers. We have begun hosting virtual town halls where members can get support from each other and where members can hear from experts in the field on topics like disaster mental health. Under the leadership of President-Elect Alice LoCicero, ACPA is also partnering with Crisis Support Services of Alameda County to create an emotional support hotline for frontline healthcare workers. We are looking for mental health practitioners to volunteer for weekly shifts on the hotline, and I do hope that you will volunteer. Be on the lookout for more virtual town halls. Ultimately, we don’t know when things will get back to “normal,” but ACPA is going to continue moving forward. Our CE Chair, Jamie Goldstein, is has planned 4 CEs for this year, with the first one scheduled for June. For the time being, we’ll be doing CEs through Zoom. We’ll also be working to schedule some more social events for members via Zoom. In addition, the Summer BBQ that we traditionally have in June is presently on hold; we are considering doing something in its place in the early fall. I want to reiterate that we are here for you, and that you can get in contact with any board member (or with me at eric@ignitechangetherapy.com) at any time. Finally, please encourage your colleagues and friends who are psychologists in Alameda County to join ACPA. Thank you!
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covid-19 resources Service and Advocacy Current Openings ACPA Announcements 2020 CE Schedule ACPA Town hall meetings
Spring Volume 1 Issue 2 2020
president's message
inside this issue
Eric A. Samuels, Psy. D
Alameda County Psychological Association ~Caring for people through responsible psychology~
Transitioning to Telehealth- Dan Quinn, PsyD
What should be considered in dealing with a crisis situation over telehealth? One of the things that I emphasize in my work is to ensure that I have a current address for all of my clients. I have been providing therapy to clients via telehealth even before the COVID-19 pandemic occurred, and I have had clients move to other parts of the state. Whenever my clients move to somewhere else, I emphasize to them that I desire that they send me their new address just in case there is an emergency situation. Whenever my clients tell me that they are moving or that they are staying in a new location for an indefinite amount of time, I usually tell my clients something like this, "suppose that you were to leave me a voicemail message or send me an email telling me that you are suicidal. I would try to call you, but you might not answer. If that were to occur, it would be important for me to know where I should send the police to." With everything going on with COVID-19, a few of my clients have left the Bay Area for more-remote locations where it'd be easier for them to avoid others. When this occurs, I have always asked them to send me their new address. Most "best practices for telehealth" encourage the therapist to have a list of crisis response resources that are close to wherever the client is and that the therapist can advise the client to utilize if there is a crisis (or that the therapist can use themselves). The challenge with telehealth, though, it's not possible to ensure that the client is where they say that they are. How do you recognize a crisis situation through various telehealth mediums and what are the ways to resolve it? Different telehealth mediums present different challenges for recognizing crisis situations. Providing therapy over videoconference presents the best opportunity to recognize whether a client is in crisis due to being able to view a client's nonverbals. Offering therapy over the phone deprives a provider of that opportunity. As such, providers conducting therapy over telehealth might be benefited by having their clients fill out more brief questionnaires and outcome measures to assess whether or not they are in crisis. Resources Treating Suicidal Patients During COVID-19 Telehealth Tips with Suicidal Patients Preventing Suicide During and After COVID-19
There has been a plethora of great resources shared on our ACPA listserv and I just wanted to capture it all in one place. In this section, you will find a variety of resources by topic for telepractice. This information includes a variety of information from online resources and interviews with professionals in the field.
Crisis Intervention & Telehealth- Eric Samuels, PsyD
Covid-19 resources
telehealth/telepractice : our new normal
Dr. Dan Quinn is a psychoanalytically oriented psychologist, working primarily with adults . He works primarily from a psychodynamic orientation , but also enages with other therapeutic techniques. He made the transition to telehealth about 2 years ago. Click on the questions to hear what he has to say about his transition. What are some main technical considerations to think of when transitioning to telehealth? What telehealth mediums have you used? Pros and cons? Part 1 Part 2 What specific therapeutic modalities do you use for telehealth? What have you found to be work well? What’s the one thing you wished you had known before taking the plunge into telehealth? What advice would you give to the clinician transitioning to telehealth? Or hesitant to engage in telehealth practice? General Telehealth Guidance from APA APA COVID-19 Information and Resources APA's Guidelines for the Practice of Telepsychology APA Article- How to make the most of telepsychology and steer clear of pitfalls “Answers to practicing psychologists’ latest questions about providing telehealth services” Teleheath Guidance by State During COVID-19
Legal and Ethical Considerations- Kelley Gin, PsyD
covid-19 resources
Ethical considerations in providing telehealth during Shelter-in-Place For our purposes, we shall refer to telehealth, telepsychology, or teletherapy synonymously as the delivery of services using real-time video-audio conferencing as distinct from telephone-based services, text or chat, or even the exchange of email. The ethical considerations for providing telehealth in general are broad and include the usual questions of provider competence, awareness of the security of the platform used to conduct services and how data is used or stored, knowledge of the risks and benefits, limitations and opportunities of treatment in a ‘virtual’ setting, and familiarity with the laws and regulations governing telehealth provision in addition to the policies and rules specific to third-party reimbursement. The reader is referred to the APA’s Practice Guidelines for Telepsychology. The ethical considerations for telehealth during our current shelter-in-place do not change our overall obligations but the exigencies of the pandemic may create an impression that there are new or different ethical duties involved. For example, while a shelter-in-place order may necessitate teletherapy for many patients, it does not prohibit in-person services if precautions are followed. Additionally, clients do not have to agree to teletherapy initially or may withdraw their consent for the service at any time. The technology involved in telehealth introduces potential challenges to maintaining confidentiality. The provider is responsible for maintaining a secure computer system through the use of robust passwords, encryption of stored and transmitted data, maintaining up-to-date computer security systems (e.g. antivirus; antimalware; operating system security updates), and using password protected private Wi-Fi. Then the provider is responsible for taking reasonable steps to learn how the platform used to provide teletherapy secures the data and whether it is stored and who has access to it. This information is usually available through the vendor. For example, here is a link to the description provided by SimplePractice, one of the electronic health record services, (https://www.simplepractice.com/security/). Since we cannot cover the breadth of ethics related to teletherapy, I want to focus on two questions that can guide decision-making in the provision of what we can call virtual or e-services. The first question is what we can call ‘would, should, and could’ and the answers to these questions will cover many ethical aspects: Would the risks outweigh the benefits of providing the service by teletherapy? What would I do when the risks outweigh the benefits? Who would I contact besides the patient in a crisis? How would I describe the risks and benefits to clients? Would it be better to see the client in person assuming all public health precautions were followed? Should I provide this service based on my scope of practice and competence? What should I do to ensure that I know how to provide this service and to assess my competence? Who should I contact for consultation or guidance in any aspect of providing this service? Could I provide this service effectively outside the office? Could I provide this service differently from my usual approach using teletherapy? To whom could I refer the patient if I am unable to see them. Do I know the laws and regulations pertaining to teletherapy including confidentiality and privacy laws and where these may differ? The second set of questions we can call ‘do’ questions. These are not restricted to ethical considerations. Do I have an informed consent section or document covering teletherapy? Do I have a place to conduct services that is quiet, free from interruptions, and from which I am able to maintain confidentiality? Do I know how to use the teletherapy platform? Do I know what is the ease of use and access for clients? Do I have a way of contacting the client if the teletherapy platform fails or is unavailable? Do I know if the platform has known performance issues that may affect connectivity or quality?
Do I know if the platform can be used for healthcare under HIPAA/HITECH (although the current pandemic has resulted in the loosening of enforcement in privacy and security practices, best practice is that psychologists use security-compliant platforms for telehealth)? Do I know if I have to provide a service from my office if it is to be reimbursed by insurance? Do I know if my professional liability insurance covers telehealth and where it is provided? Do I know if I can provide teletherapy services to a patient who is residing in another jurisdiction in which I am not licensed? Confidentiality considerations in providing telehealth and how to resolve them Our duty to maintain confidentiality is no different when applied to telehealth and must be covered as part of informed consent, or the update to informed consent when telehealth is introduced. But telehealth also introduces different variables. Psychologists must keep sessions confidential by not conducting sessions in shared spaces or if services can be disclosed whether by view or by range of hearing. This may mean not practicing from home, using a computer that is not shared by others, and using headsets during sessions. Likewise, we should remind patients that services may be most effective when conducted in a quiet or environment free from interruption in which they have privacy such as by using headsets. Not only is there the patient’s privacy to consider there may be issues affecting privilege if another person who is not a participant in the service happens to be in the space where the service is provided. An issue that has been raised more than once during the shelter-in-place relates to the use of shared computers and the browser history. A client may not want others to know that they are receiving psychological services. While this is not an aspect of confidentiality for which the provider is responsible, it is a matter of privacy for the patient. This may relate to not just privacy but personal safety. Psychologists should refer clients to learning about options for clearing their browser history or other means such as Virtual Private Network (VPN) or using private or incognito mode. Another issue of confidentiality relates to the platform used to provide teletherapy. While there has been temporary loosening of HIPAA enforcement that permits psychologists to use applications such as FaceTime, Skype, or Zoom (basic), best practice is for psychologists to only use platforms with vendors that will enter into HIPAA Business Associate Agreement (BAA) with the provider and to learn about the security features of the telehealth platform such as whether it includes end-to-end encryption and controls on who can access the information. Not all platforms or plans are covered under a BAA. For example, Zoom only offers a HIPAA BAA for its Healthcare Provider plan. But the BAA does not cover other plans, including the free option. Some IT and privacy industry individuals currently do not recommend using Zoom for healthcare operations until the company updates its security features. Apple will not enter into a BAA for practitioners who wish to use FaceTime even though it has security features similar to other platforms handling Protected Health Information (PHI). For specific professional affairs questions related to telehealth or other areas of practice, please contact me at Kelleygin@drkelleygin.com or at 510-219-7091. Other Legal and Ethical Resources A Practical Guide to Providing Telepsychology with Minimal Risk- A seminar for providing telehealth and minimizing risk for free Informed Consent Examples The Trust APA Rebecca Connell, LCSW Video Consent- Spanish version available upon request here HIPPA Compliant VIdeo Conferencing Platforms Zoom SecureVideo Clocktree Doxy Vsee Simple Practice
Dr. Byrd is a licensed psychologist, author, speaker, and entrepreneur, based out of the San Francisco Bay Area. She is passionate about leveraging technology for behavioral health innovation, and serves as an advisor for a health-tech start-up company. What kinds of offline and/or online applications/materials do you use with clients that you(or others that you know) havefound to be successful for children/ adolescents? How do you use them? Working with adolescents and families over the years I try to make sessions as interactive as possible. With adolescents I keep sessions structured and engage in a check-in, review of previous session, games, and visualizations. Prior to shelter-in-place, during in-person sessions, I would often utilize a white board, and have “fidgets” around the room such as kinetic sand and stress balls. I would also encourage clients to bring in their own interests, such as art projects, writing samples, performance art etc. What therapeutic modalities have you used with children/adolescents? Any specific tips or strategies that work well? When appropriate I use humor with adolescents and keeping sessions more “light hearted” to develop rapport. I use an integration of many orientations and interventions, but find myself being more client-centered with adolescents and using Motivational Interviewing. I also infuse concepts of Mindfulness Based Self-Compassion and CBT skills. What are some unique challenges that you (or others that you know) have found in working with children/adolescents via telehealth? What were some strategies that you’ve used to resolve them? I have compassion that it may be harder for clients and therapists alike to connect and have rapport over video. One of the greatest challenges may be keeping the session more engaging. I have been working on keeping sessions more active by using card decks and visualizations when appropriate. I am also offering more parent support and addressing topics such as creating routines, boundaries for online learning/working from home, and maintaining healthy habits during shelter-in-place. The Self-Compassion Deck by Chris Willard, Psy.D., Mitch Abblett, Ph.D. and Time Desmond, LMFT Resources for Working with Children and Adolescents National Association of School Psychologists Handouts for Parents and Educators on Supporting Children During COVID-19 Check-in Protocol for Students Conducting Suicide Intervention Virtually Therapeutic Teleheatlh Activities for Children and Adolescents Supporting You Supporting Students Webinar Series Resources Child Mind Institute-Supporting Kids During COVID-19 Greater Good-Teen Support for Shelter in Place Greater Good-Teen Support for Loss of Prom and Graduation Interactive Websites and Apps Seesaw The Social Express Kahoot! Toca Monster Toontastic
Working with Children and Adolescents- Jessica Byrd-Olmstead, PhD
Practice Concerns Insurance and Billing. Barbara Griswold, LMFT has created a resource discussing the latest status around insurance companies reimbursing video/phone sessions. The list includes billing codes as well. https://navigatingtheinsurancemaze.com/telehealthpolicies/ APA Practice Resources- Website that is updated regularly to bring you the latest news that affect your practice during COVID-19. Pandemic Unemployment Assistance- If you work as an independent contractor with reportable income, you may also qualify for PUA benefits if you are unemployed, partially employed, or unable or unavailable to work because the COVID-19 public health emergency has severely limited your ability to continue performing your customary work activities, and has thereby forced you to stop working. Small Business Association Loans- Small business "loans" are available to independent contractors, and, if you use the money for your usual income, the loan will be forgiven--it becomes more like a grant. You have to be eligible to receive the loan. This could be a significant boost to those whose practices are not easily transferred to Telehealth. The Alameda County Small Business Development Center serves as the SBA clearinghouse in this county for many SBA resources, including the Paycheck Protection Program, CARES Act Guide, and perhaps most relevant to us, free business advising. If interested in the latter, go to their website,ACSBDC.org& search for "Apply Now for Counseling". Beyond that, their website lists many constantly updated helpful resources, for ourselves and for our clients. Neurological and Psychological Testing During COVID-19 Neuropsychological and psychological testing duringCOVID-19 Guidance on CPT codes, technical requirements and more for successfully providing neuropsychology services via telehealth How to do psychological testing via telehealth Guidance on psychological tele-assessment during theCOVID-19crisis Evidence Based Neuropsychological Care During theCovid-19Pandemic TeleAssessment- What you need to Know Equivalence of Remote, Online Administration and Traditional, Face-to-Face Administration of Woodcock-Johnson IV Cognitive and Achievement Tests Clinical Best Practices for Approaching TeleAssessemnt During COVID-19 Resources for You in Your Work Helpful COVID-19 Apps and Resources for Self Care Covid Coach App- This is a mobile app created by the US Department of Veteran Affairs to help anyone manage stress, frustration, and low mood during the shelter in place. HeadSpace is offering a free subscription to their app through the end of 2020 to any mental health provider who has an NPI. Healthy Mind Innovations is offering a Healthy Minds Program app for free to all individuals - Sounds True Podcast- Resilience in Challenging Times APA- Self Care Resources for Psychologists COA- Coalesce "Therapy and Expert Led Classes for mental health, all grounded in community." A community that promotes mental health in the context of growing togther in community.
Professional Town Hall Meetings Alameda County Psychological Association Dr. Shani Dowd If You’ve Seen One Disaster, You’ve Seen One Disaster: Key Themes for Disaster Response in the Context of COVID-19 for Behavioral Health Professionals. Dr. Kaethe Weingarten Witness 2 Witness Program- Supporting Frontline Workers California Psychological Association - COVID-19 and You! -Recordings are available for free to CPA members. Santa Clara County Psychological Association-Town Hall meetings on various topics scheduled at least twice a month. Check out the website for more details. Professional Development for Telepractice (ACPA does not personally endorse any of the listed professional development resources. These are provided for you to engage in at your own discretion) PESI, Inc This website has a list of different professional development workshops for diving into telehealth Telehealth Certification Institute- Offers training and consultation on designing a telehealth practice SAMHSA Telebehavioral Health Resources and tools for implementing a telebehavioral health program Board Certified Tele-Mental Health Provider- Certification and training in the provision of telemental health services Certificate Program in Telemental Health- Offered by the Zur Institute Case Consultation Available- with Dr. Jeff Sharp Although working via telemental health can be enormously gratifying amid this pandemic, it can also add to the stress, anxiety and sense of isolation that plagues many therapists. Coping with the new stressors in our own lives--including developing competence in providing telemental health services--can complicate and intensify the demands of providing psychotherapy. Consultation Groups help practitioners overcome isolation, have a safe place to talk about clinical and professional challenges, benefit from the collective wisdom of a group of supportive, experienced colleagues, and expand one’s professional network and relationships.In response to the Covid 19 pandemic, I am expanding my Case Consultation availability for licensed psychotherapists.I am forming a new consultation group, for seasoned practitioners as well as newly licensed therapists. Short term, this could either be in individual or group format, depending upon the needs and wishes of the participants. Long term, my hope is to create a new, ongoing Consultation Group that regularly meets in person.I am a firm believer in the value and power of Consultation Groups, which have enriched my life—both as a member and as a leader--for decades. A bit about my background: I have provided Case Consultation with diverse clients in my private practice for many years, and supervision in numerous clinics, graduate schools and hospitals. I’ve had strong academic training as well as extensive training and experience providing therapy for individuals, couples, families and groups. In addition, participating for twenty-plus years in an ongoing Consultation Group, led by Irv Yalom, has enormously expanded my clinical expertise and greatly enhanced my personal and professional fulfillment. I’ve also published and presented at APA on the value of consultation and mentoring in our profession. Theoretically my work has been informed via Attachment Theory, Systems Theory, and Humanistic-Existential perspectives. I’ve trained and collaborated extensively with several luminaries within our profession, which has helped me develop integrative and relational approaches toward therapy. As a clinical consultant, my primary goal is to create a nurturing context in which psychotherapists can explore their questions, concerns, struggles, needs and options. My background and training as a Certified Group Therapist has enhanced my expertise in facilitating the deepening of cohesion and trust in groups. If you are interested in either individual or group consultation, please contact me at: DrJeffSharp@gmail.com.
ACPA Partners with crisis support services of alameda county
California Health Corps: Clinicians can sign up with the California Health Corps to support those who are affected by the outbreak Immigrant Rising: Therapists can also sign up to provide mental health support to undocumented young people impacted by COVID-19. Two members of CAMFT have started a volunteer network to support healthcare workers. See this link for more information UCSF Caring for the Caregiver Program Therapy Roots- a referral service that helps people find teletherapy options duirng COVID-19 Alameda County Food Bank Donate items to combat the hunger issues associated with COVID-19 How you can help Bay Area's Most Vulnerable
service and advocacy
Other State and local service opportunities
“STAYING STRONG AGAINST COVID-19” ACPA is partnering with Crisis Support Services of Alameda County to offer a dedicated line for workers in health care settings. Those who answer phones on this line will be either licensed mental health providers, psychological assistants, or advanced doctoral students.The line was developed in consideration of the immense stresses experienced by workers in health care settings. It is unique in that our focus includes ALL those who work in such settings, including those providing hands-on care, and also those who work in food service, maintenance, clerical roles, transport, and so on. Both scientific studies and anecdotal accounts indicate that those in health care settings during this pandemic are apt to suffer increased levels of anxiety, insomnia, depression, and general distress. We will be offering support such as active listening, empathy, and a genuine connection with a person who cares. In some situations, we will also be helping callers to consider available resources in their own networks and beyond. Calls are expected to last about fifteen minutes, and callers can call again if they choose. For anyone wanting to volunteer, we would ask that you sign up by filling out a form at the following address: https://www.surveymonkey.com/r/BV9Y9L2 For anyone wishing to assist with getting the word out about this service, we ask that you copy one of the posters and get it to appropriate settings, write about it on social media, and/or through informal channels. Please see the website for more information: www.stayingstrongagainstcovid19.org
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job openings
Practice
Fran Krieger-Lowitz, Ph.D. Contact Info: drfrankrieger@gmail.com; (510)841-2007. Specialties: Women's Issues (over 35 years of experience) Current Openings In: Mother's Group The group has met for 10 years twice a month,Thursday 12:10-1:40 , with emphasis on parenting teens and learning differences. The fee is $70 per group with most insurances accepted. Each potential member must interview with me for "goodness of fit" prior to joining the group Andrew Condey, Ph.D Contact Info: DrCondey@aol.com; 510-525-5660, X-1 Website: DrCondey.com Current Openings: Space for 1 new member in ongoing Psychotherapy/support Group for individuals wanting to focus on enhancing relationship skills, self expression, and expanding one's sense of self empowerment. An ongoing group of well functioning members. Meets Thursday evgs. Space for 1 new senior clinician in Mindful Legacy Group. Meet with colleagues for deep sharing about issues of aging, retirement, creativity, and focusing on personal and professional legacies. Meets Monday AM La Familia Counseling- Program Supervisor for men's residential substance use recovery home (El Chante). Other exciting job openings (e.g., staff therapist) are also available across the diverse departments at La Familia: https://www.lafamiliacounseling.org/careers Jason Zeltser, PhD Contact Info: drjasonczeltser@gmail.com; (925) 405-6399 Website: drjasonczeltser.com Current Practice Openings I have openings for individual psychotherapy and couples therapy using a reliable and easy to use telehealth video platform. Specializing in concerns related to anxiety, relationship struggles and major life changes (e.g., career). Lynne Henderson, PhD Contact Info: lhenderson@rivcons.com; 650-814-9210 I have openings in my private practice in Berkeley. I use HIPAA compliant zoom.
The 2020 ACPA CE Schedule is here! Dr. Jamie Goldstein has worked hard to line up exciting CE events for the rest of this year. Please see the schedule below and mark your calendars! May 30, 2020 (Zoom CE)- Kermit Crawford, Ph.D Dr. Crawford will be speaking to disaster response & addressing the current pandemic June 28, 2020 (Zoom /In Person)- Reba Connell, LCSW Nourishing Client Mood: MIndfulness & Nutrition Mental Health for Therapists August 8, 2020- Marcella Raimondo, PhD, MPH Eating Disorders: Hidden Dangers and How to Address them in your Clinic & Practice October 10, 2020- Pearl Werfel, PhD & Rhoda Olkin, PhD Effective Therapy with Clients with Chronic Illness/Disability November 11, 2020 Ilene Wolf, MFT Essential Interactive Hypnotherapy Tools to Build Motivation in Angry Clients Stay tuned for our ACPA Town Hall Meetings as we navigate COVID-19 together. We will get through this!
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Current opennings
acpa announcements
In subsequent newsletters, we would like to feature articles written by the membership on mental health and psychological topics that can enhance our abilities to support our community. If you would like to write an article, please email Crystal.