The Spring APA Council meeting began with new APA CEO Arthur C. Evans Jr, PhD, giving his report of what he has seen at APA and what he thinks its needs are. He proposed the formal development of a new strategic plan, but in the meantime, moving forward with implementing changes that he believes will enable APA to better serve the needs of the members. Primarily among these are enhanced capacity for legislative lobbying in Congress, agency lobbying (e.g., National Institute for Mental Health, Department of Defense, etc.) and political action on behalf of psychology—its practice, its basic and applied sciences, educational support (e.g., among the STEM) and public interest issues (current clear example is origins of violence). To do this, Evans argues, requires a restructuring of APA so that additional resources can be put into these efforts. As a step forward, it is proposed that APA members, when they pay their dues, will be joining both the current 501(c)(3) scientific organization with a public interest mission but at the same time joining a 501(c)(6) lobbying organization, (which is yet to be named but which I suggested should be named APA in Action) that is allowed to do direct and specific lobbying. Dues would be divided between these two functions. All the existing, 501(c)(3) resources and incomes such as those from the journals and buildings would remain in the current APA and support the functions and activities they have in the past—but hopefully with sharper foci. The Council voted overwhelmingly in favor of this (something like 90 percent pro) to start in 2019. This is expected to result in increased legislative and political action on behalf of science, practice, education and public interest starting in 2019. Goodness knows, we do need it if we are to compete for resources at the federal level.
You will see this change in the structure of your dues statement this autumn. But note that there will be no increase in dues for 2019 - 2021. (By the way did you notice that there was a dues decrease for 2018—small but still a decrease?)
Evans and the Board of Directors have also sequestered $20,000,000 for new strategic initiatives from the new plan.
Speaking of budgets and management, the 2017 budget anticipated a $4,000,000 deficit but in fact ended the year with a tiny surplus, not a major deficit. This required tight management at all levels in the organization and careful leadership and financial management.
Going forward, because our assets in the two building and in the investment portfolio have grown so substantially, the plan is to draw from the building operations a portion of the profits and from the investment portfolio a portion of dividends and possibly from growth for operations. The IRS requires that tax exempt charities, including 501(c)(3)s, not be vehicles for accrual of wealth but support their missions; IRS has often used a 5 percent guidance and indeed imposed this on some charities. This draw on basic resources is easily supported now. You should not worry about APA’s financial health at the present time. Of course, we all need to keep an alert eye on the future.
APA is in the process of developing clinical practice guidelines under strict guidance from the National Institute of Health (NIH) for assessing efficacy of treatments and stratifying treatments on the bases of efficacies. Why should science divisions care about this clinical issue? For one, because it is a genuine science-based enterprise and guided collaboratively by the Science Directorate.
The first one was passed last year focusing on post-traumatic stress disorder (PTSD). It is in many was an exemplary review of the empirical literature and especially the experimental literature using randomized control trials (RCTs) to assess efficacy. It is a data-driven review. Some colleagues have complained, fairly so, that the guidelines do not fully recognize that some treatments that seemed to have small effect sizes were nonetheless effective. The guidelines will stimulate more research and better assessments going forward, and the guidelines must be revised in five years, a process that will start soon.
A second Clinical Practice Guideline on Behavioral Treatment of Obesity in Children was before council at this spring meeting. The discussion for almost an hour would have made your heart sing; the calls, “Where are the data?” kept coming for many of the contents. In the end, they were renamed to include in the title a call for more research to provide foundations for further treatments. The APA Science Directorate provides the context document concerning clinical guidelines, "Placing Clinical Practice Guidelines in Context." The PTSD Guideline website also includes a link to this context document.
The clinical guidelines are important to both practice and science. If you want to have NIH recognize treatments for diseases and disorders, the guidelines process is how you do it. It is important for science because it puts data foremost and it can guide further research, both basic and applied. NIH (including NIMH, NIDA, etc.), for example, is by mandate supportive only of research that can be seen to contribute to health. To the extent that applied research shows efficacy of psychological treatments, then our research becomes more fundable.
In addition to these clinical practice guidelines, there are other levels of guidelines such as professional practice guidelines and other levels of such. These different kinds of guidelines can get a bit confusing — at least to me. The professional practice guidelines too are based on survey of the literature including that beyond experimental and RCTs and are intended to be advisory. One example is the just passed Guidelines for Psychological Practice with Girls and Women. Council also passes resolutions based on the professional literature and sometimes science that are meant to provide broader prospective on issues. One such this time was the resolution on Pregnant and Postpartum Adolescent Girls and Women with Substance-Related Disorders. Council also commonly receives substantive reports. Again this time, we received one from the Working Group on Health Disparities in Vulnerable Boys and Men entitled “Health Disparities in Racial/Ethnic and Sexual Minority Boys and Men.” I found the 75-page, data-based report and the 20 pages of comments on it to be exceedingly informative, and I commend it to all who might have even a tangential interest.
Diversity of the psychological workforce continues to be a focus of Council. How to foster greater diversity among our students to map onto the U.S. population has been and continues to be a challenge. It is also lacking in APA membership and leadership as well. Old, straight, white guys like me remain most common, but it is changing slowly. The challenge is how to speed up this representative process. The diversity issue seems also to come with calls for a more “civil” Council functioning. But in my view, civility is being conflated with “niceness.” Actually, I rarely see incivility on Council (except for intrusive calls for a vote when many still have ideas to offer), but comments can be challenging to some sacred views or lead some people to feel hurt when their views are ignored. Gosh, my views (and those of science in general) have often been ignored. That is not incivility; I am not “hurt” by that, but I do sometime get disappointed. Civility is no guarantee against disappointment or even offence. (There is a lovely book of “insults” that are beautifully phrased.) Some on Council really want everyone to feel loved, but that is not why I go to Council nor is that the real world of competing ideas. Anyhow, APA is spending time and money on addressing diversity and tries to write rules about it without being discriminatory.
APA, as you know, assesses and accredits doctoral training programs in some areas. It is proposing to do so in those same areas at the masters’ level. A lot of ground work needs to be covered before that can happen. A start was in the passage of Guidelines on Core Learning Goals for Master’s Degree Graduates in Psychology. This should be protective of the public. And specific guidelines for health care psychologists could lead to bringing masters’ persons back into APA if scopes of practice can be put into place that satisfy all. But that is some way off at this point. Part of this is because some counseling organizations are accrediting programs and working in legislatures to have it so that on graduates of those programs can do psychological counseling. So, there is an element of fighting against restraint of trade in the APA action plan.
There was more in the 1,000 pages of the Council agenda. But I have touched on the things I think are of most general interest to Div. 3.