Some Specific Ideas

I am taking the opportunity to share with you a variety of possible ideas as to how we can make APA more collaborative and effective in addressing the needs of our working psychologists and their communities. If you have ideas you want to share or have comments about any of the ideas below, write me at chuckatmopa@gmail.com.

Strengthening Collaboration and APA’s Advocacy Infrastructure

Those who know me know that I strongly support APA’s Advocacy Office and its Practice, Education, and Science departments. These areas are essential to advancing psychology’s future. We need to make sure they are fully staffed and adequately resourced, with a clear focus on meeting the needs of working psychologists and supporting the communities they serve. We also need to ensure that this work is shaped collaboratively with the SPTAs and Divisions, so that priorities, strategy, and projects are informed by those closest to the field’s real-world needs. A good example of this was the openness of the Advocacy Office’s Alix Ginsberg and the Practice Department’s Dr. Lynn Bufka to proposals for presentations by APA Division 31 and the SPTAs at this year’s Practice State Leadership Conference. The collaboration led to a more vibrant and useful conference.

Benefitting from State-Level Advocacy

The most important decisions about scope of practice and reimbursement are often made at the state level. APA should identify legislative proposals across the country with the greatest potential to strengthen psychology, such as the Illinois reimbursement law that guarantees behavioral health providers payment at 140% of the Medicare rate. We should then make sure interested state associations have the tools, information, and support they need to pursue similar legislation.

Making Better Use of Division Expertise

Collaboration must be central to how APA works. Division representatives on Council have repeatedly said that their expertise is too often overlooked, even in areas where they have deep knowledge. When APA is considering advocacy in a particular content area, we should begin by turning to the Divisions and drawing directly on their expertise.

Creating a Presidential Task Force on Reimbursement

Psychologists need a focused, practical effort aimed at improving reimbursement. APA should create a Presidential task force charged with identifying concrete strategies to strengthen payment for psychological services and to advance those strategies at both the federal and state levels.

Educating the Public About Psychologists

Too many people still do not understand who psychologists are, what we do, or the value we bring. APA should lead a national campaign with high-quality marketing materials designed to educate employers, insurers, policymakers, and the public about psychologists’ roles, skills, and contributions.

Clarifying Psychology’s Unique Expertise

Physicians are widely recognized for their expertise in the medical complexity of physical health. We need the same level of understanding when it comes to psychology’s expertise in behavioral and mental health. Employers, insurance companies, policymakers, and the public should clearly understand the depth of training psychologists bring to assessment, diagnosis, treatment, consultation, and behavior change.

Continuing Strong Federal Advocacy

Over the past two years, Martha Turner Quest, Executive Director from North Carolina, and I have worked with Stephen Gillaspy, Deputy Chief for Health Policy and Healthcare Financing, to encourage SPTAs to send formal letters to the Centers for Medicare & Medicaid Services in support of proposed rules that affect practicing psychologists, including rules related to audio-only telehealth and reimbursement methodology. We should continue and strengthen that practice. Is it time to bring this effort to issues like seeing psychologists included in the physician definition under Medicare?

Helping Psychology Evolve

Other professions, including nursing and osteopathy, have recognized that professions must evolve over time. That evolution has produced major gains. It helped establish DOs as equivalent to MDs, and it helped nursing build the nurse practitioner movement. Psychology should be asking the same question: how does our profession need to evolve to remain strong and relevant in a changing healthcare and workforce environment?

Rethinking Doctoral Training

Increasingly, a master’s degree in behavioral health is treated as the basic behavioral healthcare degree. That raises an important question for psychology. Is it time to stop treating the doctoral degree as primarily a generalist degree and instead help students develop stronger cross-disciplinary expertise in areas such as law, consulting, business administration, hospital administration, psychopharmacology, and technology?

Securing Time-Free Codes and Supervision Pathways

Physicians have benefited greatly from access to time-free codes and to coding structures that allow them to supervise and be reimbursed for the work of extenders. Psychologists need similar opportunities. This is both a fairness issue and a mental health parity issue. Our reimbursement system should better reflect the cognitive complexity, supervisory expertise, and system-level contributions psychologists provide.

Creating Better Pathways for Practice Advocacy in APA

Many Council members are frustrated that APA’s Council of Representatives has little meaningful ability to advance issues affecting practice. What is passed is typically limited to new treatment guidelines. What is passed in Council is largely limited to public interest matters. APA needs a stronger and more visible process through which members can advocate for the needs of working psychologists. Existing but underused pathways include the Board of Directors and the Board of Professional Practice, but these need to be more understood, accessible, active, and transparent.

Supporting Social Justice Advocacy Across Different State Cultures

APA has clear social justice values. To advance any social justice agenda, we need respectful and thoughtful messaging that works in states with cultures and political environments very different from those of blue states. Advocacy cannot be one-size-fits-all. At a minimum, APA should provide a support structure for advocates working in red states, where the challenges, language, and political realities may be very different.

Supporting States That Cannot Afford a DPA

One of the most effective groups in APA for addressing insurance, regulatory, and reimbursement issues is the network of Directors of Professional Affairs (DPAs). Unfortunately, fewer than half of SPTAs can afford to have a DPA, and many of the states that cannot are smaller and more rural. APA should create a second support structure specifically for states that do not have a DPA, so they are not left without guidance in the areas that matter most to practicing psychologists.

Addressing Student Debt

If we want a strong future for psychology, we have to address student debt. The cost of doctoral training is too high, and that burden affects who enters the field, who stays, and where they are able to serve. It can push talented students away from public service, rural communities, and other high-need settings. Access to affordable education is not only a practice-relevant issue, but a social justice issue as well. We need to do whatever is necessary to support APA in its efforts to help students manage student debt. This would include supporting stronger loan forgiveness pathways, protecting affordable repayment options, and expanding workforce incentives for students and early career psychologists who serve in underserved areas.

Artificial Intelligence

The rule in medicine is Do No Harm. We need to find the balance between the use of AI to elevate clinical practice, while ensuring that its darker side does not harm our children and adolescents. I like a list of advocacy points offered by APA’s Deborah Baker, Head, Office of Professional Legal & Regulatory Affairs. She is in favor of legislation that:

1. Regulates the specific act: Ban the representation of AI as a licensed professional by unlicensed entities and the provision of services by AI technology where there is no health care provider involvement.

2. Protects the licensee: Explicitly states “Nothing in this act shall be construed to limit the ability of a licensed psychologist to utilize AI-enabled tools or technologies within their scope of practice and ethical obligations.”

3. Removes the double standard: If an exemption exists for physicians, it must exist for psychologists.