Council of Representatives Approved Minutes: August 5 & 9, 2009
I. MINUTES OF MEETING
A.(1) Council voted to approve the minutes of its February 20-22, 2009, meeting.
II. ELECTIONS, AWARDS, MEMBERSHIP AND HUMAN RESOURCES
A.(2) Council voted to postpone to its February 2010 meeting the item “Members Dues Schedule Revision: Amendment to Association Rules.”
B.(3) Council voted to request that Article XIX, Section 3, of the Bylaws be amended and forwarded to the Membership for a vote as follows (bracketed material to be deleted; underlined material to be
Dues and Subscriptions
The basic Association dues to be paid annually by Members and Associate members shall be determined by Council and shall include subscriptions to such publications as may be determined by Council. In addition to the basic dues, each Member shall pay a fixed amount, to be determined by Council, for each Division over and above one to which the Member belongs.
The annual fees to be paid by International Affiliates, High School Teacher Affiliates, and Student Affiliates, and the publications of the Association to which they shall be entitled, shall be determined by Council.
Nonpayment of dues for [two] one [consecutive] year[s] shall be considered as equivalent to a request for resignation from the Association.
Council also voted to request that the Association Rules be amended as follows (bracketed material to be deleted; underlined material to be added):
10-10. TERMINATION OF MEMBERSHIP
10-10.1 Membership in the Association may be terminated by the death of a member, resignation, dropping for nonpayment of dues, or as provided in the Ethics Committee’s Rules and Procedures.
Notice of the death of a member or formal resignation should be forwarded to APA Central Office. Resignation will ordinarily be accepted forthwith, except while a member is under scrutiny by the Ethics Committee. While under such scrutiny, a member may be permitted to resign under stipulated conditions in accordance with provisions in the Ethics Committee's Rules and Procedures.
A member is dropped from membership in the Association after nonpayment of dues [two calendar years during which dues to the Association have remained unpaid. “Benefit of membership” subscriptions (such as the APA Monitor on Psychology) will not be continued during this period of grace] by January 1 of the year after dues have been unpaid for one year, except while a member is under the scrutiny by the Ethics Committee. Members dropped after nonpayment of dues will be considered voluntary resignations from the Association.
10 10.2 A member may resign from any division by not paying the dues or assessment of that division in connection with the annual Association dues statement.
10-11. REINSTATEMENT OR READMISSION
10-11.1 The membership of a person who has voluntarily resigned [or who has been dropped for nonpayment of dues] may be fully reinstated at any time by the payment of all [delinquent and] current dues. Prior to such reinstatement, the person must indicate any prior unethical conduct and make the ethics affirmation in accordance with the procedures of Association Rule 10-4 and is subject to investigation by the Ethics Committee as provided in its Rules and Procedures for applicants. Reinstatement is effective as of the current year. The period of [nonpayment of dues] voluntary resignation shall not be counted towards the years needed to attain dues-exempt status. When fully reinstated, the person’s membership dates from the original year of election. This option shall not be available to a former member who was under scrutiny by the Ethics Committee at the time membership was terminated.
[10-11.2 The membership of a person who has voluntary resigned or who has been dropped for nonpayment of dues may be reinstated upon payment of dues for the current year. Reinstatement is effective as of the current year. The period of nonpayment of dues shall not be counted toward the years needed to attain dues exempt status. This option can be used only once and shall not be available for former members who were under scrutiny by the Ethics Committee at the time membership was terminated.]
10 11.3 A person whose membership has been terminated under the provisions of Article II, Section  16 of the APA Bylaws or who has resigned while under the scrutiny of the Ethics Committee may request reinstatement of membership under the conditions stated in Article II, Section  17. Accordingly, the Membership Board will automatically inform the Ethics Committee of all such reinstatement requests and the Ethics Committee shall be responsible for furnishing the Membership Board with a recommendation as provided in its Rules and Procedures.
10-11.4 Ordinarily, individuals who have previously resigned or been expelled from membership must reinstate into the previously held membership status and dues category and may not reapply as a new member. Exceptions regarding the membership status and dues category of reinstating members may be made by the chief staff officer or the Membership Board.
C.(3A) Council voted to elect 101 members to initial Fellow status, on the nomination of the indicated divisions and on the recommendation of the Fellows Committee and the Board of Directors.
D.(3B) Council voted to approve amending Association Rule 110-8.3 as follows (bracketed material to be deleted; underlined material to be added):
110 8. PRESIDENT ELECT ELECTION
110 8.1 The election of APA President elect is conducted by the Election Committee.
110-8.2 Candidates are nominated by Fellows, Members, and Associate members with
voting privileges. Nominations are made by preferential ballots, and up to five names may be listed in rank order. Nomination ballots are sent on or about February 1. The balloting period closes within 45 days. Only APA members are eligible for nomination.
110 8.3 The APA President elect shall be elected by Fellows, Members, and those Associate members who have been granted voting privileges. The election ballot shall be preferential and shall list five candidates. Final election ballots shall be sent on or about [October] September 15. The balloting period shall close within 45 days.
Each candidate is invited to submit a statement, to be sent with the election ballot, of no more than 1,000 words, stating his or her opinion of issues facing psychology and of the role APA should play regarding these issues.
110-8.4 Results are reported to the Board of Directors. Tallied results are reported to Council no more than 30 days after the ballot closes. Election results are published in the APA Monitor on Psychology in the earliest issue possible.
A.(4) Council voted to approve the following motion in response to concerns regarding ethical standards 1.02 and 1.03:
Council directs the APA Ethics Committee to propose language to Council that will resolve the discrepancy between the language of the Introduction and Applicability Section of the Ethical Principles of Psychologists and Code of Conduct and the Ethical Standards 1.02 and 1.03 so that these Standards can never be used to justify, or as a defense for, violating basic human rights. This process shall be completed in time for the Ethics Committee’s proposed language to be acted on as part of Council’s February 2010 meeting agenda;
WHEREAS when Council adopted the 2002 Ethics Code, it was not anticipated or intended that the language of Standards 1.02 and 1.03 be interpreted to mean that any psychologist in any role could use these Standards to justify, or as a defense for, violating basic human rights. Standard 1.02 addresses conflicts between ethics and law, regulations or other governing legal authority. Standard 1.03 addresses conflicts between ethics and organizational demands;
WHEREAS in 2005 Council members learned that the Introduction and Applicability Section of the Ethics code is aspirational and not enforceable. It states: "If psychologists' ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists make known their commitment to this Ethics Code and take steps to resolve the conflict in a responsible manner. If the conflict is unresolvable via such means, psychologists adhere to the requirements of the law, regulations, or other governing authority in keeping with basic principles of human rights." In contrast, Standard 1.02 states, "If psychologists' ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists make known their commitment to the Ethics Code and take steps to resolve the conflict. If the conflict is unresolvable via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority." Standard 1.03 states, "If the demands of an organization with which psychologists are affiliated or for whom they are working conflict with this Ethics Code, psychologists clarify the nature of the conflict, make known their commitment to the Ethics Code, and to the extent feasible, resolve the conflict in a way that permits adherence to the Ethics Code”;
WHEREAS, in 2005 Council directed the APA Ethics Committee to “review the discrepancy between the language of the Introduction and Applicability section of the Ethical Principles of Psychologists and Code of Conduct (2002) and Ethical Standard 1.02 and,” requested that the Ethics Committee “make a recommendation to the Board of Directors concerning adding the words ‘in keeping with basic principles of human rights’ to Ethical Standard 1.02”;
WHEREAS it was Council’s intent in giving the Ethics Committee this charge that the Committee consider various approaches and wording in order to resolve the discrepancy;
WHEREAS, in August 2008, the movers introduced New Business Item #34E directing the Ethics Committee to suggest language that would resolve the discrepancy. The main motion suggests, as one possible approach, adding the phrase “in keeping with basic human rights”;
WHEREAS in July 2009 the Ethics Committee issued its response to Council’s 2005 directive in which it noted that “the language of Ethical Standard 1.03 closely tracks the language of Standard 1.02,” and also reiterated a central distinction in the Ethics Code “between the Code’s aspirational sections—the Introduction and Applicability, the Preamble, and the Ethical Principles—and the enforceable ethical standards.” In contrast to the general language of the aspiration sections, language in the enforceable standards “is specific and directive” and sets forth “specific obligations and specific prohibitions on psychologists’ behavior”;
WHEREAS in July 2009 the Ethics Committee acknowledged the discrepancy between the aspirational section of the Ethics Code (Introduction and Applicability Section) and the enforceable section, but did not propose any language to resolve it. Instead the Ethics Committee recommended against adding the one phrase, “in keeping with basic principles of human rights,” to Ethical Standard 1.02 or 1.03;
WHEREAS the July 2009 response does not report that the Ethics Committee considered any other approaches or wording possibilities to resolve the discrepancy other than adding the words “in keeping with basic principles of human rights”;
WHEREAS Council acknowledges and appreciates the Ethics Committee’s work on this issue, however, the pressing need to resolve the discrepancy remains so that Ethical Standards 1.02 and 1.03 can never be used to justify or as a defense for violating basic human rights;
WHEREAS there is no plan, timeline or allocated funds for a revision of the entire Ethics Code;
WHEREAS the Ethics Committee received comments in last year’s Call for Comments about 1.02, including concerns raised about the effects of language changes on disclosure of confidential information in response to a legal demand such as a subpoena or court order, the Ethics Committee should consider these comments as it proposes language to ensure that Ethical Standards 1.02 and 1.03 can never be used to justify or as a defense for violating basic human rights;
WHEREAS the Ethics Committee’s June 2009 statement, “No Defense Against Torture,” is insufficient because it solely prohibits torture and is neither contained nor referenced in the Ethics Code itself;
WHEREAS according to The Association Rules (2008) Code 20-4.1, titled, Review of the Ethics Code, "The Ethics Committee shall have the responsibility from time to time of initiating a review of the latest formally adopted version of the ethics code or any part of the code and proposing necessary changes or additions. In carrying out such a review, the Ethics Committee may set up such ad hoc committees as it finds necessary;”
THEREFORE BE IT RESOLVED that Council directs the APA Ethics Committee and the other relevant Boards, Committees and constituencies to move forward expeditiously to recommend language to Council that will resolve the discrepancy between the language of the Introduction and Applicability Section of the Ethical Principles of Psychologists and Code of Conduct and Ethical Standards 1.02 and 1.03;
BE IT RESOLVED that the language proposed for Council's action clearly communicate that Ethical Standards 1.02 and 1.03 can never be interpreted to justify or as a defense for violating basic human rights;
BE IT RESOLVED that this entire process be completed in time for the Ethics Committee to make a formal recommendation for proposed language to be acted on as part of Council’s February 2010 meeting agenda.
IV. BOARD OF DIRECTORS
A.(5) Council voted to approve the following motion:
Council requests that diversity training on the topic of “Current Findings on Discrimination: Causes and Interventions” be provided to Council at its February 2010 meeting and to boards and committees at the March 2010 Consolidated Meeting.
B.(6) Council voted to approve 1) suspending Association Rule 210-2.10 and 2) reducing the 2009 President-elect discretionary fund by $3800 and increasing the 2010 President discretionary fund by $3800 so that unused funds from 2009 can be put towards the presidential initiatives of Carol D. Goodheart, EdD, in 2010.
C.(7) Council voted to receive the Report of the Presidential Working Group on the Representation of Diversity on the Council of Representatives.
Council also voted to request that one non-voting delegate from each of the four National Ethnic Minority Psychological Associations be invited to continue to attend Council meetings for an additional three years (2010-2012) with the understanding that the delegates will serve as consultants to the process of developing next steps based on the recommendations of the Report of the Presidential Working Group on the Representation of Diversity on the Council of Representatives. Furthermore, the delegates will continue to receive full reimbursement for their attendance at the February and August meetings. Council affirms that in 2007 and 2008 it voted in support of a Bylaw amendment to be voted upon by the membership to seat representatives of the four National Ethnic Minority Psychological Associations.
Council also requested that the Report of the Presidential Working Group on the Representation of Diversity on the Council of Representatives be referred to the Committee on Ethnic Minority Affairs, the Committee on Structure and Function of Council and the Policy and Planning Board.
D.(41) Council received information regarding continuing implementation of the petition resolution.
E. In executive session, Council voted to support the Board's decision to pursue litigation with the American Psychological Association Insurance Trust to obtain the information that the APA Board has been seeking.
V. DIVISIONS AND STATE AND PROVINCIAL AND TERRITORIAL ASSOCIATIONS
A.(8) Council voted to postpone to its February 2010 meeting the item “Ensuring All Divisions and State, Provincial and Territorial Psychological Associations a Seat on the Council of Representatives.”
B.(49) Council received an update on the new-business-in-progress item “Change in Association Rule 90-6 to Clarify Role of CODAPAR in the Agenda Planning Group.”
VI. ORGANIZATION OF THE APA
A.(9) Council voted to refer the item “APA’s Tax Status” to the Committee for the Advancement of Professional Practice with a request that the item come back to Council at its February 2010 meeting.
B.(10) Council voted to approve the following motions for Guidelines and Standards included in the Council Policy Manual:
1) That Ethical Guidelines for the Teaching of Psychology in the Secondary Schools be archived.
2) That Guidelines for the Specialty Training and Certification of Secondary School Teachers of Psychology be archived.
3) That Guidelines for the Use of Drugs in Research by Psychologists be archived.
4) That the expiration date of the document Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists be extended to 2011.
C.(11) Council voted to approve the following motions for Policies Included in the Council Policy Manual:
1) That Council archives the 2004 policy Identifying Priorities
2) That Council archives the 1949 policy Management of the Association’s Journals
3) That Council archives the 1970 policy on the Psychological Bulletin vs. Psychological Review:
4) That Council approves a revision to the 1971 policy on Complimentary Subscriptions (Brackets indicate deletions and underlining indicates additions):
2009 Complimentary Subscriptions
(a) A member of the [Publications Board (now] Publications and Communications Board[,] shall, during the term of office, be entitled to receive (complimentary subscriptions to all journals. )the electronic Gold Package, delivered by PsycNET. P&C Board members retiring from the board after July, 2009 shall receive the electronic Gold Package, delivered by PsycNET for life.
(b) An editor of an APA journal shall be entitled, during the term office, to receive complimentary (subscriptions to all APA journals) electronic Gold Package, delivered by PsycNET, and shall be entitled to receive for life a complimentary print subscription and complimentary electronic access to the journal he or she edited.
(c) Associate editors of APA journals shall be entitled, as long as they serve in these capacities, to receive a complimentary print subscription and complimentary (subscriptions) electronic access to the journal which they serve. (and such other journals as are required to serve their purposes for their work on a specific journal.)
(d) Consulting editors of APA journals shall be entitled, as long as he or she serves a specific journal, to receive a complimentary print subscription to that journal.
5) That Council archives the 1986 policy on the Use of Aversive Techniques in Treating Alcoholism
6) That Council archives the 1986 policy On Drug and Alcohol Treatment as Sub-issues of ‘Substance Abuse’
7) That Council archives the 1989 policy on psychology’s role in diagnosis, assessment, training and treatment of mental retardation (Division 33)
8) That Council archives the 1998 policy on APA Activities Bearing on Licensure Changes:
9) That Council approves a revision to the 1995 policy Psychological Needs of Children Exposed to Disasters
…Whereas disasters are increasing sources of human dysfunction (Hurricane Andrew, Midwest floods), as urban areas grow in population and geographic area/spread, as rural areas fall further behind in access to resources, as technology expands the potential for accidents and negative side effects (Three-Mile Island), and as the rise in international terrorism increases the probability that U.S. sites will be targeted (1992 New York's World Trade Center);…
D.(12) Council voted to approve the following Goals and Objectives as part of APA’s Strategic Plan:
Goal 1: Maximize Organizational Effectiveness
The APA’s structures and systems support the organization’s strategic direction, growth and success.
a. Enhance APA programs, services and communications to increase member engagement and value;
b. Ensure the ongoing financial health of the organization;
c. Optimize APA’s governance structures and function.
Goal 2: Expand Psychology’s Role in Advancing Health
Key stakeholders realize the unique benefits psychology provides to health and wellness and the discipline becomes more fully incorporated into health research and delivery systems.
a. Advocate for the inclusion of access to psychological services in health care reform policies
b. Create innovative tools to allow psychologists to enhance their knowledge of health promotion, disease prevention, and management of chronic disease;
c. Educate other health professionals and the public about psychology's role in health;
d. Advocate for funding and policies that support psychology's role in health;
e. Promote psychology's role in decreasing health disparities;
f. Promote the application of psychological knowledge for improving overall health and wellness at the individual, organizational, and community levels.
Goal 3: Increase recognition of psychology as a science
The APA’s central role in positioning psychology as the science of behavior leads to increased public awareness of the benefits psychology brings to daily living.
a. Enhance psychology’s prominence as a core STEM (Science, Technology, Engineering, and Mathematics) discipline;
b. Improve public understanding of the scientific basis for psychology;
c. Expand the translation of psychological science to evidence-based practice;
d. Promote the applications of psychological science to daily living;
e. Expand educational resources and opportunities in psychological science.
Council voted to postpone to its February 2010 meeting action on the Core Values for APA.
VII. PUBLICATIONS AND COMMUNICATIONS
A.(13) Council voted to approve the Division 47 request for authorization to publish a divisional journal, to be tentatively titled Sport, Exercise, and Performance Psychology.
B.(14) Council voted to approve the Division 52 request to sponsor a new journal, tentatively entitled International Perspective in Psychology: Research, Practice, and Consultation.
VIII. CONVENTION AFFAIRS
IX. EDUCATIONAL AFFAIRS
A.(15) Council voted to approve the proposal for the establishment of an APA designation program for education and training programs in psychopharmacology.
Council also voted to adopt as APA policy, 1) the 2007 Recommended Postdoctoral Education and Training Program in Psychopharmacology for Prescription Privileges (with minor revisions), and 2) the 2007 Model Legislation for Prescriptive Authority.
B.(16) Council voted to approve the renewal of recognition of the Assessment and Treatment of Serious Mental Illness as a proficiency in professional psychology for a period of seven years, to be reviewed again in 2016 unless otherwise warranted by provisions outlined in the CRSPPP Procedures for Recognition of Specialties and Proficiencies in Professional Psychology.
C.(17) Council voted to approve an extension for recognition of Sport Psychology as a proficiency in professional psychology for an additional period of six months until August 2010.
D.(18) Council voted to grant an extension of recognition of Psychopharmacology as a proficiency in professional psychology for a period of one year until August 2010.
E.(19) Council voted to approve the continued recognition of Family Psychology as a specialty in professional psychology for a period of seven years, to be reviewed again in 2016 unless otherwise warranted by provisions outlined in the CRSPPP Procedures for Recognition of Specialties and Proficiencies in Professional Psychology.
F.(20) Council voted to approve an extension for recognition of Industrial-Organizational Psychology as a specialty in professional psychology for an additional period of six months until August 2010.
G.(21) Council voted to approve changing the name of the specialty from Behavioral Psychology to Behavioral and Cognitive Psychology. Council also voted to grant an extension of the recognition of Cognitive and Behavioral Psychology as a specialty in professional psychology for a period of one year until August 2010.
H.(42) Council received information regarding the 2008 National Conference on Undergraduate Education in Psychology.
X. PROFESSIONAL AFFAIRS
A.(22) Council voted to adopt the following resolution as APA policy:
Resolution on APA Endorsement Of
The Concept Of Recovery For People With Serious Mental Illness
INTRODUCTION: The traditional view of serious mental illness, especially psychotic disorders, is that they have at best a stable course with chronic disability and poorer-than-premorbid functioning, and at worst a chronic deteriorating course. As a result, treatment has typically focused on symptom reduction and relapse prevention, and has been characterized by low expectations with little focus on issues such as living environment, relationships, work, and education. This is now changing. A wealth of data now indicate that the majority of people with serious mental illness eventually improve significantly over time, and can have independent lives that include striving for personal meaning and enhanced quality of life through active efforts in the above domains (e.g., relationships, work), regardless of whether symptoms are present or not. Moreover, research indicates that these areas are important sources of self-esteem for consumers, and are some of their most highly rated goals for treatment. In addition, federal and state agencies are now recommending that the paradigm for treatment of serious mental illness shift away from symptom-oriented care, to this more comprehensive view of how treatment can be envisioned. This new vision for foci of treatment, informed by long-term outcome data suggesting that it is realistic, has been labeled recovery-oriented treatment. It is important to note that the concept of recovery-oriented care does not assume a specific etiology for serious mental illness, nor does it recommend or contraindicate any specific treatments. Rather, it is a vision for a person-based approach to treatment, and a method of treatment delivery that is sensitive to consumer-defined goals and recognizes the need to at tend to a range of psychological factors (e.g., identity, self-esteem) as part of an expanded definition of what a positive outcome represents. In the resolution below, a detailed set of points is reviewed to clarify the definition of, and rationale for, the concept of “recovery.” This is followed by recommendations regarding how APA can help to promote this concept and thereby influence both how treatment is provided and the outcomes that are achieved.
WHEREAS as noted in the APA Resolution on Stigma and Discrimination against People with Serious Mental Illness and Severe Emotional Disturbance (1999), the Center for Mental Health Services reports that 5.4 million or 2.7 percent of the adult population has a "severe and persistent" mental illness, such as schizophrenia, bipolar disorder or major depression;
WHEREAS the Center for Mental Health Services (CMHS, 1993), in accordance with PL 102 321 (1992), has defined serious mental illness (SMI) as “a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified by DSM-IV, and that has resulted in functional impairments which substantially interfere with or limit one or more major life activities;”
WHEREAS, as stated in the APA Resolution on Stigma and Discrimination against people with Serious Mental Illness and Severe Emotional Disturbance (1999), the CMHS definition further notes that “functional impairment is defined as difficulties that substantially interfere with or limit role functioning in one or more major life activities including basic daily living skills (e.g., eating, bathing, dressing), instrumental living skills (e.g., managing money, maintaining a household, taking prescribed medication, or functioning in social, family, and vocational/educational contexts) and that adults who would have met the functional impairment criteria during the year without the benefit of treatment or other support services are considered to have a serious mental illness;”
WHEREAS, APA has previously endorsed a resolution on Stigma and Discrimination against People with Serious Mental Illness and Severe Emotional Disturbance (1999);
WHEREAS, a proficiency which contains language clearly expressing a recovery orientation in the Assessment and Treatment of Serious Mental Illness has been recognized by APA;
WHEREAS the concept of “recovery” is a core theme in the President’s New Freedom Commission Report (2003), which states that: 1) “the system is not oriented to the single most important goal of the people it serves-the hope of recovery;” 2) “the system should foster recovery, resilience, and independence;” and 3) “Research and personal testimony confirm that “recovery from mental illness is real: there are a range of effective treatments, services, and supports to facilitate recovery;”
WHEREAS recovery has been defined as “A deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness” (Anthony, 1993);
WHEREAS the process of recovery includes “that people overcome the effects of being a mental patient - including rejection, poverty, substandard housing, isolation, unemployment, loss of valued social roles and identity, loss of sense of self and purpose in life, and the iatrogenic effects of involuntary hospitalization, medication and other treatments - in order to retain, or resume, some degree of control over their lives” (Davidson, O’Connell, Tondora, Staeheli, & Evans, 2005);
WHEREAS recovery involves “a redefinition of one’s illness as only one aspect of a multi-dimensional sense of self capable of identifying, choosing, and pursuing, personally meaningful goals and aspirations despite continuing to suffer the effects and side effects of mental illness” (Davidson, et al., 2005);
WHEREAS the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a National Consensus Statement on Mental Health in which it defined recovery as a "journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential" (SAMHSA, 2005);
WHEREAS the Department of Veterans Affairs is changing its regulations and practice standards to implement recovery-oriented care;
WHEREAS the Department of Justice is promoting recovery-oriented care;
WHEREAS the Joint Commission has incorporated standards that address recovery oriented services for persons with severe mental illness;
WHEREAS the National Association of State Mental Health Program Directors (NASMHPD) issued a report supporting recovery-oriented care in 2004 (NASMHPD/NTAC, 2004);
WHEREAS states, agencies, and other organizations have published guidelines for recovery-oriented care (e.g., Connecticut DMHAS, 2006; Onken, Dumont, Ridgway, Dornan, & Ralph, 2002; Sainsbury Centre for Mental Health, 2004; Young, Forquer, Tran, Starzynski, & Shatkin, 2000);
WHEREAS, as noted in the APA Resolution on Outpatient Civil Commitment (2004), all people have a right to the opportunity for recovery, namely, full participation in society to the best of their ability;
WHEREAS numerous longitudinal research studies indicate that the majority of people with SMI can improve their functional status and move into valued social roles (e.g., spouse, employee, student) over time (e.g., Bleuler, 1978; Ciompi, 1980; DeSisto, Harding, McCormick, Ashikaga, & Brooks, 1995a,b; Harding, Brooks, Ashikaga, Strauss, & Breier, 1987; Harrow et al., 2005; Huber, Gross, & Schuttler, 1975; Huber, Gross, Schuttler, & Linz, 1980; Jablensky, Sartorius, Ernberg, Anker, Korten, Cooper et al., 1992; Ogawa, Miya, Watarai, Nakazawa, Yuasa, & Utena, 1987; Sartorius, Jablensky, & Shapiro, 1977; Tsuang, Woolson, & Fleming, 1979);
WHEREAS these longitudinal data supporting recovery from SMI are consistent with findings that even people diagnosed with schizophrenia who have spent years in state hospitals and are considered treatment-refractory can be discharged to live back in the community after receiving intensive social-learning based inpatient services (Corrigan & Liberman, 1994; Paul & Lentz, 1977; Silverstein, Wong, Wilkniss, Bloch, Smith, Savitz, et al., 2006);
WHEREAS short term outcome data (1-2 years) also support the idea that recovery is possible (Edwards, Maude, McGorry, Harrigan, & Cocks, 1998; Gitlin, Nuechterlein, Subotnik, Ventura, Mintz, Fogelson, et al., 2001; Maslin, 2003; Loebel, Lieberman, Alvir, Mayerhoff, Geisler, & Szymanski, 1992; Whitehorn, Richard, & Kopala, 2004);
WHEREAS converging data on positive long-term outcomes of people with serious mental illness, and on the personal meanings of recovery have come from countries all over the world (Cohen, Patel, Thara, & Gureje, 2008; Jablensky et al. 1992; Ng, Pearson, Lam, Law, Chiu, & Chen, et al. 2008; Sartorius et al. 1977; Warner, 1983);
WHEREAS despite the general similarities in outcomes and subjective experiences related to recovery in different countries, cultural variation in the expression of serious mental illness and attitudes towards serious mental illness exist, and these must be taken into account in conceptualizing and implementing recovery-oriented care for individual persons;
WHEREAS recovery for some individuals or groups involves religious coping as a way to maintain control of their lives (Yangarber-Hicks, 2004). Research has shown that patterns of religious coping differ between ethnic groups (Bhui et al., 2008);
WHEREAS life challenges associated with recovery are common human experiences that require resilience. Resilience across cultures involves resolving tensions in relationships and cultural adherence (Ungar et al., 2007). Resilience is “...both a characteristic of the individual…and a quality of …environment which provides the resources necessary for positive development despite adverse circumstances” (Ungar et al., 2007);
WHEREAS the “research and clinical literature on resilience has focused largely if not exclusively on individual personality traits and coping styles, and has neglected to explore all possible sources and expressions of resilience in individuals and groups. For many ethnic minorities, traditional notions of resilience, shaped largely by middle class European and North American values, may not capture culturally more familiar modes of positive adaptation to adverse and traumatic experience” (Tummala-Nara, 2007);
WHEREAS research indicates that recovery is not an inevitable outcome of SMI, but that it is a function of the availability of comprehensive and coordinated psychological interventions (e.g., Harding et al., 1987b);
WHEREAS despite the existence of evidence-based practices, there are often environmental barriers to accessing potentially beneficial services. Moreover, the research literature suggests that these disparities are more severe for minorities and people of lower socioeconomic status, and that general disparities in health care lead to people with SMI dying, on average, 25 years earlier than expected. In addition, women with schizophrenia are more likely to have experienced severe trauma (e.g., physical or sexual abuse) and to have comorbid post-traumatic stress disorder, and therefore to be at risk for especially poor outcomes and further comorbidity (e.g., substance abuse) if this is not diagnosed and treated;
WHEREAS although most people with SMI will experience a significant improvement in functioning over the long term, some people will need long-term intensive treatment and supports and continue to experience significant disability; even in these cases, however, recovery-oriented principles, such as shared decision making, and a focus on multiple dimensions of outcome may improve quality of life;
WHEREAS most discussions of recovery focus on subjective experience as the domain that is most critical for promoting recovery, the extent of recovery is likely to be significantly affected by community and societal values regarding mental illness, and the extent to which people undergoing a process of recovery are accepted as valued members of their communities and the society at large.
WHEREAS as noted in the APA Resolution on Outpatient Civil Commitment (2004), a key ingredient in recovery from serious mental illness is making choices for oneself and developing skills necessary to make those choices (Anthony & Liberman, 1992);
WHEREAS as noted in the APA Resolution on Outpatient Civil Commitment (2004), clinical application of psychological methods (including neuropsychological, behavioral, sociocognitive, and functional assessments and interventions) holds substantial promise for enhancing skill development, including skills relevant to recovery from serious mental illness and skills relevant to making competent personal choices (Spaulding, Sullivan, & Poland, 2003);
WHEREAS recovery-oriented interventions such as supported employment, supported housing, and supported education have demonstrated greater effectiveness than traditional interventions for people with SMI (Drake & Bellack, 2005; Mueser, Clark, Haines, Drake, McHugo, Bond, et al., 2004);
WHEREAS the integration of psychological interventions with interventions seen as paradigmatic of recovery can lead to outcomes that are superior than with either intervention alone (e.g., cognitive rehabilitation, when added to supported employment, significantly improves vocational outcomes for people with SMI compared to supported employment alone) (McGurk, Mueser, Feldman, Wolfe, & Pascaris, 2007);
WHEREAS recovery-oriented care is consistent with evidence-based treatment (Bond, Salyers, Rollins, Rapp, & Zipple, 2004; Frese, Stanley, Kress, & Vogel-Scibilia, 2001);
WHEREAS psychologists are well qualified by training and experience, as well as well positioned in both service delivery and policy development roles, to promote such transformation and champion the adoption of recovery-oriented services, including training staff in, and delivery of recovery-oriented interventions in mental health settings;
WHEREAS research conducted by psychologists has identified psychological constructs that are involved in the recovery process (e.g., hope, self-efficacy, self-determination, empowerment, changing personal narratives) (e.g., Lysaker, Lancaster, & Lysaker, 2003; Roe 2001, 2003), and that can form the basis for more effective psychological therapies;
WHEREAS reliable and valid assessment instruments to assess individual staff members on the extent to which they have adopted a recovery orientation, and to assess agencies’ growth towards recovery oriented services, are now increasingly used (e.g., Campbell-Orde, Chamberlin, & Leff, 2005; Chinman, Young, Rowe, Forquer, Knight, & Miller, 2003; O'Connell, Tondora, Croog, Evans, & Davidson, 2005; Ridgway & Press, 2004);
WHEREAS recovery is now routinely the subject of books; articles in scientific journals in the fields of psychology, nursing, and psychiatry, articles in consumer-oriented publications such as Schizophrenia Digest, and papers given at local, national, and international conferences;
WHEREAS the American Psychological Association has yet to develop or issue a position on the concept of recovery as it applies to SMI;
THEREFORE BE IT RESOLVED that the American Psychological Association (APA) endorses the concept of recovery as it applies to SMI.
BE IT FURTHER RESOLVED that APA will issue a position statement noting this endorsement, and that this statement will be actively promulgated to the public and appear on the APA website.
BE IT FURTHER RESOLVED that APA will work toward increasing the attention to promoting data-driven views on the realities of long-term outcomes for people with serious mental illness, and to the importance of consumer-defined and community reintegration-centered goals in conceptualizing treatment, in graduate and post-graduate training.
BE IT FURTHER RESOLVED that psychologists be encouraged to continue to promote the development, implementation, and rigorous evaluation of recovery-oriented services.
BE IT FURTHER RESOLVED that, consistent with the principles of recovery, that these efforts involve consumer input and other forms of active collaboration with consumers.
BE IT FURTHER RESOLVED that psychologists be encouraged to support and promote staff training and public education efforts designed to increase awareness of recovery-oriented concepts and treatment.
BE IT FURTHER RESOLVED that psychologists be encouraged to support and promote efforts at stigma reduction, with the understanding that the extent of recovery is partly a function of the degree to which people with SMI are accepted as valued individuals in their communities.
BE IT FURTHER RESOLVED that psychologists be encouraged to conduct further research on the outcomes of recovery-oriented interventions.
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Frese, F. J., Stanley, J., Kress, K., & Vogel-Scibilia, S. (2001). Integrating evidence-based practices and the recovery model. Psychiatric Services, 52, 1462-1468.
Gitlin, M., Nuechterlein, K., Subotnik, K. L., Ventura, J., Mintz, J., Fogelson, D. L., Bartzokis, G., & Aravagiri, M. (2001). Clinical outcome following neuroleptic discontinuation in patients with remitted recent-onset schizophrenia. American Journal of Psychiatry, 158, 1835-1842.
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B.(23) Council voted to approve the assignment of February 21, 2019, as an expiration date for Guidelines for Child Custody Evaluations in Family Law Proceedings (approved as APA Policy by the APA Council of Representatives in February 2009).
C.(24) Council voted to approve the withdrawal of Council New Business Item #34D: Model Research on the Efficacy of the Prescribing Psychologist.
D.(24A) Council voted to adopt as APA policy the proposed Guidelines Regarding Psychologists’ Involvement in Pharmacological Issues.
E.(36) Council received an update on the business pending item “Infusing the Association Guidelines in the Public Interest Which Have Been Adopted by Council for Psychologists Throughout APA.”
F.(37) Council received an update on the business pending item “Revision of APA’s Statement on Parental Alienation Syndrome.”
G.(38) Council received an update on the business pending item “Ad Hoc Task Force to Investigate the
Merits, Needs, and Outcomes of An Evidence Based Practice Policy for Applied Psychologists and the
Benefits of Collaborating with International Associations Interested in Developing EBP Policy for Applied
H.(43) Council received as information an update regarding the Revision of APA’s Model Act for State
Licensure of Psychologists.
I.(44) Council received as information an update regarding the contribution of psychology to the revision
of the Mental Health chapter of the International Classification of Diseases and Related Disorders.
J.(45) Council received information regarding BPA’s work to develop tools and materials to support and
facilitate guidelines development, revision and review.
K.(50) Council received an update on the new-business-in-progress item, “Best Practice Guidelines on Prevention, Practice, Research, Training and Social Advocacy for Psychologists.”
L.(51) Council received an update on the new-business-in-progress item, “Structure and Function of an Interdisciplinary Team for Persons with Acquired Brain Injury.”
M.(52) Council received an update on the new-business-in-progress item, “Submission of Revised Specialty Guidelines for Forensic Psychology for comment, review and revision, consistent with APA Rule 30.8.”
XI. SCIENTIFIC AFFAIRS
A.(25) Council voted to receive the report of the Task Force on the Interface Between Psychology and Global Climate Change.
B.(26) Council voted to reduce the annual contribution to the Archives of the History of American Psychology to $20,000 in 2010. Council also voted that Council must reauthorize the continuation and amount of the annual contribution every three years beginning with the 2011 contribution.
Paul L. Craig, PhD, recused himself from voting on this item.
C.(53) Council received an update on the new-business-in-progress item, “Proposal for an American Institute of Psychology.”
XII. PUBLIC INTEREST
A.(27) Council voted to receive the report Multicultural Competency in Geropsychology.
B.(28) Council voted to adopt the following resolution as APA policy:
Resolution on Appropriate Affirmative Responses to
Sexual Orientation Distress and Change Efforts
The longstanding consensus of the behavioral and social sciences and the health and mental health professions is that homosexuality per se is a normal and positive variation of human sexual orientation (Bell, Weinberg & Hammersmith, 1981; Bullough, 1976; Ford & Beach 1951; Kinsey, Pomeroy, & Martin, 1948; Kinsey, Pomeroy, Martin, & Gebhard, 1953). Homosexuality per se is not a mental disorder (APA, 1975). Since 1974, the American Psychological Association (APA) has opposed stigma, prejudice, discrimination, and violence on the basis of sexual orientation and has taken a leadership role in supporting the equal rights of lesbian, gay, and bisexual individuals (APA, 2005).
APA is concerned about ongoing efforts to mischaracterize homosexuality and promote the notion that sexual orientation can be changed and about the resurgence of sexual orientation change efforts (SOCE)(1). SOCE has been controversial due to tensions between the values held by some faith-based organizations, on the one hand, and those held by lesbian, gay and bisexual rights organizations and professional and scientific organizations, on the other (Drescher, 2003; Drescher & Zucker, 2006). Some individuals and groups have promoted the idea of homosexuality as symptomatic of developmental defects or spiritual and moral failings and have argued that SOCE, including psychotherapy and religious efforts, could alter homosexual feelings and behaviors (Drescher & Zucker, 2006; Morrow & Beckstead, 2004). Many of these individuals and groups appeared to be embedded within the larger context of conservative religious political movements that have supported the stigmatization of homosexuality on political or religious grounds (Drescher, 2003; Southern Poverty Law Center, 2005; Drescher & Zucker, 2006). Psychology, as a science, and various faith traditions, as theological systems, can acknowledge and respect their profoundly different methodological and philosophical viewpoints. The APA concludes that psychology must rely on proven methods of scientific inquiry based on empirical data, on which hypotheses and propositions are confirmed or disconfirmed, as the basis to explore and understand human behavior (APA, 2008a; 2008b).
In response to these concerns, APA appointed the Task Force on Appropriate Therapeutic Responses to Sexual Orientation to review the available research on SOCE and to provide recommendations to the Association. The Task Force reached the following findings.
Recent studies of participants in SOCE identify a population of individuals who experience serious distress related to same sex sexual attractions. Most of these participants are Caucasian males who report that their religion is extremely important to them (Beckstead & Morrow, 2004; Nicolosi, Byrd, & Potts, 2000; Schaeffer, Hyde, Kroencke, McCormick, & Nottebaum, 2000; Shidlo & Schroeder, 2002, Spitzer, 2003). These individuals report having pursued a variety of religious and secular efforts intended to help them to change their sexual orientation. To date, the research has not fully addressed age, gender, gender identity, race, ethnicity, culture, national origin, disability, language, and socioeconomic status in the population of distressed individuals.
There are no studies of adequate scientific rigor to conclude whether or not recent SOCE do or do not work to change a person’s sexual orientation. Scientifically rigorous older work in this area (e.g., Birk, Huddleston, Miller, & Cohler, 1971; James, 1978; McConaghy, 1969, 1976; McConaghy, Proctor, & Barr, 1972; Tanner, 1974, 1975) found that sexual orientation (i.e., erotic attractions and sexual arousal oriented to one sex or the other, or both) was unlikely to change due to efforts designed for this purpose. Some individuals appeared to learn how to ignore or limit their attractions. However, this was much less likely to be true for people whose sexual attractions were initially limited to people of the same sex.
Although sound data on the safety of SOCE are extremely limited, some individuals reported being harmed by SOCE. Distress and depression were exacerbated. Belief in the hope of sexual orientation change followed by the failure of the treatment was identified as a significant cause of distress and negative self-image (Beckstead & Morrow, 2004; Shidlo & Schroeder, 2002).
Although there is insufficient evidence to support the use of psychological interventions to change sexual orientation, some individuals modified their sexual orientation identity (i.e., group membership and affiliation), behavior, and values (Nicolosi, Byrd, & Potts, 2000). They did so in a variety of ways and with varied and unpredictable outcomes, some of which were temporary (Beckstead & Morrow, 2004; Shidlo & Schroeder, 2002). Based on the available data, additional claims about the meaning of those outcomes are scientifically unsupported.
On the basis of the Task Force’s findings, the APA encourages mental health professionals to provide assistance to those who seek sexual orientation change by utilizing affirmative multiculturally competent (Bartoli & Gillem, 2008; Brown, 2006) and client-centered approaches (e.g., Beckstead & Israel, 2007; Glassgold, 2008; Haldeman, 2004; Lasser & Gottlieb, 2004) that recognize the negative impact of social stigma on sexual minorities(2) (Herek, 2009; Herek & Garnets, 2007) and balance ethical principles of beneficence and nonmaleficence, justice, and respect for people’s rights and dignity (APA, 1998, 2002; Davison, 1976; Haldeman, 2002; Schneider, Brown, & Glassgold, 2002).
WHEREAS The American Psychological Association expressly opposes prejudice (defined broadly) and discrimination based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socioeconomic status (American Psychological Association, 1998, 2000, 2002, 2003, 2005, 2006, 2008b);
WHEREAS The American Psychological Association takes a leadership role in opposing prejudice and discrimination (APA, 2008b, 2008c), including prejudice based on or derived from religion or spirituality, and encourages commensurate consideration of religion and spirituality as diversity variables (APA, 2008b);
WHEREAS Psychologists respect human diversity including age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status (APA, 2002) and psychologists strive to prevent bias from their own spiritual, religious, or non-religious beliefs from taking precedence over professional practice and standards or scientific findings in their work as psychologists (APA, 2008b);
WHEREAS Psychologists are encouraged to recognize that it is outside the role and expertise of psychologists, as psychologists, to adjudicate religious or spiritual tenets, while also recognizing that psychologists can appropriately speak to the psychological implications of religious/spiritual beliefs or practices when relevant psychological findings about those implications exist (APA, 2008b);
WHEREAS Those operating from religious/spiritual traditions are encouraged to recognize that it is outside their role and expertise to adjudicate empirical scientific issues in psychology, while also recognizing they can appropriately speak to theological implications of psychological science (APA, 2008b);
WHEREAS The American Psychological Association encourages collaborative activities in pursuit of shared prosocial goals between psychologists and religious communities when such collaboration can be done in a mutually respectful manner that is consistent with psychologists’ professional and scientific roles (APA, 2008b);
WHEREAS Societal ignorance and prejudice about a same-sex sexual orientation places some sexual minorities2 at risk for seeking sexual orientation change due to personal, family, or religious conflicts, or lack of information (Beckstead & Morrow, 2004; Haldeman, 1994; Ponticelli, 1999; Shidlo & Schroeder, 2002; Wolkomir, 2001);
WHEREAS Some mental health professionals advocate treatments based on the premise that homosexuality is a mental disorder (e.g., Nicolosi, 1991; Socarides, 1968);
WHEREAS Sexual minority children and youth are especially vulnerable populations with unique developmental tasks (Perrin, 2002; Ryan & Futterman, 1997), who lack adequate legal protection from involuntary or coercive treatment (Arriola, 1998; Burack & Josephson, 2005; Molnar, 1997) and whose parents and guardians need accurate information to make informed decisions regarding their development and well-being (Cianciotto & Cahill, 2006; Ryan & Futterman, 1997); and
WHEREAS Research has shown that family rejection is a predictor of negative outcomes (Remafedi, Farrow, & Deisher, 1991; Ryan, Huebner, Diaz, & Sanchez, 2009; Savin-Williams, 1994; Wilber, Ryan, & Marksamer, 2006) and that parental acceptance and school support are protective factors (D’Augelli, 2003; D’Augelli, Hershberger & Pilkington, 1998; Goodenow, Szalacha, & Westheimer, 2006; Savin-Williams, 1989) for sexual minority youth;
THEREFORE BE IT RESOLVED That the American Psychological Association affirms that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality regardless of sexual orientation identity;
BE IT FURTHER RESOLVED That the American Psychological Association reaffirms its position that homosexuality per se is not a mental disorder and opposes portrayals of sexual minority youths and adults as mentally ill due to their sexual orientation;
BE IT FURTHER RESOLVED That the American Psychological Association concludes that there is insufficient evidence to support the use of psychological interventions to change sexual orientation;
BE IT FURTHER RESOLVED That the American Psychological Association encourages mental health professionals to avoid misrepresenting the efficacy of sexual orientation change efforts by promoting or promising change in sexual orientation when providing assistance to individuals distressed by their own or others’ sexual orientation;
BE IT FURTHER RESOLVED That the American Psychological Association concludes that the benefits reported by participants in sexual orientation change efforts can be gained through approaches that do not attempt to change sexual orientation;
BE IT FURTHER RESOLVED That the American Psychological Association concludes that the emerging knowledge on affirmative multiculturally competent treatment provides a foundation for an appropriate evidence-based practice with children, adolescents and adults who are distressed by or seek to change their sexual orientation (Bartoli & Gillem, 2008; Brown, 2006; Martell, Safren & Prince, 2004; Ryan & Futterman, 1997; Norcross, 2002);
BE IT FURTHER RESOLVED That the American Psychological Association advises parents, guardians, young people, and their families to avoid sexual orientation change efforts that portray homosexuality as a mental illness or developmental disorder and to seek psychotherapy, social support and educational services that provide accurate information on sexual orientation and sexuality, increase family and school support, and reduce rejection of sexual minority youth;
BE IT FURTHER RESOLVED That the American Psychological Association encourages practitioners to consider the ethical concerns outlined in the 1997 APA Resolution on Appropriate Therapeutic Response to Sexual Orientation (American Psychological Association, 1998), in particular the following standards and principles: scientific bases for professional judgments, benefit and harm, justice, and respect for people’s rights and dignity;
BE IT FURTHER RESOLVED That the American Psychological Association encourages practitioners to be aware that age, gender, gender identity, race, ethnicity, culture, national origin, religion, disability, language, and socioeconomic status may interact with sexual stigma, and contribute to variations in sexual orientation identity development, expression, and experience;
BE IT FURTHER RESOLVED That the American Psychological Association opposes the distortion and selective use of scientific data about homosexuality by individuals and organizations seeking to influence public policy and public opinion and will take a leadership role in responding to such distortions;
BE IT FURTHER RESOLVED That the American Psychological Association supports the dissemination of accurate scientific and professional information about sexual orientation in order to counteract bias that is based in lack of knowledge about sexual orientation; and
BE IT FURTHER RESOLVED That the American Psychological Association encourages advocacy groups, elected officials, mental health professionals, policy makers, religious professionals and organizations, and other organizations to seek areas of collaboration that may promote the wellbeing of sexual minorities.
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Burack, C., & Josephson, J. J. (2005). A report from “Love won out: Addressing, understanding, and preventing homosexuality” Minneapolis, Minnesota, September 18, 2004. New York: National Gay and Lesbian Task Force Policy Institute.
Cianciatto, J. & Cahill, S. (2006). Youth in the crosshairs: The third wave of ex-gay activism. New York: National Gay and Lesbian Task Force Policy Institute.
D’Augelli, A. R. (2003). Lesbian and bisexual female youths aged 14 to 21: Developmental challenges and victimization experiences. Journal of Lesbian Studies, 7(4), 9-29.
D’Augelli, A. R., Hershberger, S. L., & Pilkington, N. W. (1998). Lesbian, gay, and bisexual youth and their families: Disclosure of sexual orientation and its consequences. American Journal of Orthopsychiatry, 68(3), 361-371.
Davison, G. C. (1976). Homosexuality: The ethical challenge. Journal of Consulting and Clinical Psychology, 44(2), 157-162.
Drescher, J. (2003). The Spitzer study and the culture wars. Archives of Sexual Behavior, 32(5), 431-432.
Drescher, J., & Zucker, K. J. (Eds.). (2006). Ex-gay research: Analyzing the Spitzer study and its relation to science, religion, politics, and culture. New York: Harrington Park Press.
Ford, C. S., & Beach, F. A. (1951). Patterns of sexual behavior. New York: Harper & Row.
Glassgold, J. M. (2008). Bridging the divide: Integrating lesbian identity and Orthodox Judaism. Women and Therapy, 31(1), 59-73.
Goodenow, C., Szalacha, L., & Westheimer, K. (2006). School support groups, other school factors, and the safety of sexual minority adolescents. Psychology in the Schools, 43(5), 573-589.
Haldeman, D. C. (1994). The practice and ethics of sexual orientation conversion therapy. Journal of Consulting and Clinical Psychology, 62, 221-227.
Haldeman, D. C. (2002). Gay rights, patient rights: The implications of sexual orientation conversion therapy. Professional Psychology: Research and Practice, 33, 200-204.
Haldeman, D. C. (2004). When sexual and religious orientation collide: Considerations in working with conflicted same-sex attracted male clients. The Counseling Psychologist, 32, 691-715.
Herek, G. M. (2009). Sexual stigma and sexual prejudice in the United States: A conceptual framework. In D. A. Hope (Ed.), Contemporary perspectives on lesbian, gay, & bisexual identities: The 54th Nebraska symposium on motivation (pp. 65-111). New York: Springer.
Herek, G. M. & Garnets, L. D. (2007). Sexual orientation and mental health. Annual Review of Clinical Psychology, 3, 353-375.
James, S. (1978). Treatment of homosexuality II. Superiority of desensitization/arousal as compared with anticipatory avoidance conditioning: Results of a controlled trial. Behavior Therapy, 9, 28-36.
Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. Philadelphia: W.B. Saunders.
Kinsey, A. C., Pomeroy, W. B., Martin, C. E., & Gebhard, P. (1953). Sexual behavior in the human female. Philadelphia: Saunders.
Lasser, J. S., & Gottlieb, M. C. (2004). Treating patients distressed regarding their sexual orientation: Clinical and ethical alternatives. Professional Psychology: Research and Practice, 35, 194-200.
Martell, C. R., Safren, S. A., & Prince, S. E. (2004). Cognitive-behavioral therapies with lesbian, gay, and bisexual clients. New York: Guildford.
McCarn, S. R., & Fassinger, R. E. (1996). Revisioning sexual minority identity formation: A new model of lesbian identity and its implications for counseling and research. The Counseling Psychologist, 24, 508-534.
McConaghy, N. (1969). Subjective and penile plethysmograph responses following aversion-relief and Apomorphine aversion therapy for homosexual impulses. British Journal of Psychiatry, 115, 723-730.
McConaghy, N. (1976). Is a homosexual orientation irreversible? British Journal of Psychiatry, 129, 556-563.
McConaghy, N., Proctor, D., & Barr, R. (1972). Subjective and penile plethysmography responses to aversion therapy for homosexuality: A partial replication. Archives of Sexual Behavior, 2(1), 65-79.
Molnar, B. E. (1997). Juveniles and psychiatric institutionalization: Toward better due process and treatment review in the United States. Health and Human Rights, 2(2), 98-116.
Morrow, S. L., & Beckstead, A. L. (2004). Conversion therapies for same-sex attracted clients in religious conflict: Context, predisposing factors, experiences, and implications for therapy. The Counseling Psychologist, 32, 641–650.
Nicolosi, J. (1991). Reparative therapy of male homosexuality. Northvale, NJ: Jason Aronson.
Nicolosi, J., Byrd, A. D., & Potts, R. W. (2000). Retrospective self-reports of changes in homosexual orientation: A consumer survey of conversion therapy clients. Psychological Reports, 86, 1071-1088.
Norcross, J. C. (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. New York: Oxford University Press.
Perrin, E. C. (2002). Sexual orientation in child and adolescent health care. New York: Kluwer/Plenum.
Ponticelli, C. M. (1999). Crafting stories of sexual identity reconstruction. Social Psychology Quarterly, 62(2), 157-172.
Remafedi, G., Farrow, J. A., & Deisher, R. W. (1991). Risk factors of attempted suicide in gay and bisexual youth. Pediatrics, 87, 869–875.
Ryan, C. & Futterman, D. (1997). Lesbian and gay youth: Care and counseling. Adolescent Medicine: State of the Art Reviews, 8(2), 207-374.
Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in White and Latino lesbian, gay, and bisexual young adults. Pediatrics, 129(1), 346-352.
Savin-Williams, R. C. (1989). Parental influences on the self-esteem of gay and lesbian youths: A reflected appraisals model. Journal of Homosexuality, 17(1/2), 93-109.
Savin-Williams, R. C. (1994). Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: Associations with school problems, running away, substance abuse, prostitution, and suicide. Journal of Consulting and Clinical Practice, 62, 261–269.
Schaeffer, K. W., Hyde, R. A., Kroencke, T., McCormick, B., & Nottebaum, L. (2000). Religiously motivated sexual orientation change. Journal of Psychology & Christianity, 19, 61-70.
Schneider, M. S., Brown, L., & Glassgold, J. (2002). Implementing the resolution on appropriate therapeutic responses to sexual orientation: A guide for the perplexed. Professional Psychology: Research and Practice, 33, 265-276.
Shidlo, A., & Schroeder, M. (2002). Changing sexual orientation: A consumer’s report. Professional Psychology: Research and Practice, 33, 249-259.
Socarides, C. W. (1968). The overt homosexual. New York: Grune & Stratton.
Southern Poverty Law Center. (2005, Spring). A mighty army. Intelligence Report, Issue 117. Retrieved May 14, 2009, from http://www.splcenter.org/intel/intelreport/article.jsp?aid=524.
Spitzer, R. L. (2003). Can some gay men and lesbians change their sexual orientation? Two hundred participants reporting a change from homosexual to heterosexual orientation. Archives of Sexual Behavior, 32, 403–417.
Tanner, B. A. (1974). A comparison of automated aversive conditioning and a waiting list control in the modification of homosexual behavior in males. Behavior Therapy, 5, 29-32.
Tanner, B. A. (1975). Avoidance training with and without booster sessions to modify homosexual behavior in males. Behavior Therapy, 6, 649-653.
Ullerstam, L. (1966). The erotic minorities: A Swedish view. New York: Grove.
Wilber, S., Ryan, C., & Marksamer, J. (2006). CWLA, Best practice guidelines. Washington, DC: Child Welfare League of America.
Wolkomir, M. (2001). Emotion work, commitment, and the authentication of the self: The case of gay and ex-gay Christian support groups. Journal of Contemporary Ethnography, 30, 305-334
C.(29) Council voted to receive the Final Report of the Task Force on Appropriate Therapeutic
Responses to Sexual Orientation.
D.(30) Council voted to adopt the following resolution as APA policy:
Resolution on Families of Incarcerated Offenders
WHEREAS in 2005, nearly 2.2 million Americans, or 1 in every 136 U.S. residents, were incarcerated in state or federal prisons or local jails (Harrison & Beck, 2006);
WHEREAS at the end of 2004, over 4.9 million adult men and women were under federal, state, or local probation or parole jurisdiction (Glaze & Palla, 2005);
WHEREAS, nearly 6 in 10 persons in local jails were ethnic or racial minorities (Harrison & Beck, 2006) and, at the end of 2004, 60% of state and federal prisoners were black or Hispanic (Harrison & Beck, 2005);
WHEREAS more than half (54%) of federal prisoners are serving time for a drug offense, but only 11% are incarcerated for a violent offense (The Sentencing Project, 2006);
WHEREAS changes in policies related to drug arrests contributed to an 888% increase between 1986 and 1995 in the number of women incarcerated for drug offenses (Mauer, Potter, & Wolf, 1999) and a 114% increase from 1990 to 2001 in the number of women incarcerated overall (Lee, Genty, & Laver, 2005);
WHEREAS 64% of mothers in state prisons and 84% in federal prisons were living with their children at the time of their admission to prison; in contrast, only half of incarcerated fathers were living with their children at the time of their incarceration (44% for state and 55% for federal prison) (Parke & Clarke-Stewart, 2002);
WHEREAS research suggests that offenders and their families 1 face complex and often severe psychological, medical, educational, economic, social, and spiritual challenges (Lewis, Shanok, & Balla, 1979, Seymour, 1998);
WHEREAS on June 30, 2005, the majority of all jail and prison inmates had a mental health problem and female inmates had higher rates of mental health problems than male inmates (James & Glaze, 2006; Abram, Teplin, & McClelland, 2003; Lamb & Weinberger, 1998);
WHEREAS the high rate of incarceration in the U.S. has been devastating socially and economically to children, their families, and communities (Family Strengthening Policy Center, 2005);
WHEREAS more than 2 million children had a parent behind bars in 2004, and approximately 10 million, or 1 in 8 of America’s children had experienced parental incarceration at some point in their lives (Bernstein, 2004);
WHEREAS when parents are incarcerated, the care giving arrangements for children frequently are disrupted, and mothers, grandparents, aunts, uncles, and foster parents often must raise children often without much financial or social support (Travis, 2005);
WHEREAS when a father is incarcerated, children and their mothers may suffer economically from the loss of financial support (Travis, McBride, & Solomon, 2005);
WHEREAS when a mother is incarcerated, children are most likely to live with their grandparents (Travis, McBride, & Solomon, 2005);
WHEREAS research has shown that grandparents caring for their grandchildren often experience mental health problems, such as anxiety, depression, and low life satisfaction (Gerard, Landry-Meyer, & Roe (2006);
WHEREAS children with incarcerated mothers and fathers are at very high risk of a variety of emotional and behavioral problems because of the stress of separation from their parent, stigma associated with having an imprisoned parent, loss of emotional support, fear for their parent’s safety, and uncertainty or confusion about what has happened to their parent (Seymour, 1998);
WHEREAS it has been estimated that as much as 70% of young children (ages 2 to 6 years old) with a mother incarcerated have displayed symptoms that research suggests are associated with insecure attachments, including internalizing problems such as anxiety, withdrawal, hyper vigilance, depression, shame and guilt, and externalizing behaviors such as anger, aggression, and hostility toward caregivers and siblings (Baunach, 1985; Johnson, 1995; Parke & Clarke-Steward, 2003);
WHEREAS children with incarcerated parents are six times more likely than their peers to become criminally involved and incarcerated during their lives (Bilchik, Seymour, & Kreisher, 2001);
WHEREAS families of inmates typically receive few services, and they often lack even basic support and information as they deal with the offender’s prosecution, punishment, and reentry (Travis, Solomon, & Waul, 2001);
WHEREAS some families of inmates have been doubly victimized – by the offender himself or herself and unintentionally by the system that fails to provide them with adequate support (Travis, Solomon, & Waul, 2001);
WHEREAS research indicates that policies and practices, including prison visitation policies, often make maintenance of relationships difficult when a family member is incarcerated, and that the lack of support to families of offenders can weaken family ties and make family reunification even more difficult when the offender is released (Travis, 2005);
WHEREAS nearly 95% of offenders in state prisons will eventually be released (Hughes & Wilson, 2004) without support, most will face multiple barriers to successful reintegration, including difficulty in accessing health, mental health, and drug and alcohol treatment services (Travis, 2005);
WHEREAS federal initiatives to facilitate offender reentry are underemphasizing the needs and contributions of family members despite research that documents the importance of the family in the reentry process (Travis, Solomon, & Waul, 2001);
WHEREAS all of these issues apply as well to families of juveniles in the juvenile and criminal justice systems (some of whom are parents themselves) and the juveniles themselves;
WHEREAS psychologists can and should contribute significantly to advancing the state of knowledge regarding families of offenders, including their children; and
WHEREAS the American Psychological Association is committed to promoting the health and well-being of children, youth, and families,
THEREFORE, BE IT RESOLVED that the American Psychological Association urges:
(a) the National Institute of Mental Health, the National Institute of Drug Abuse, the National Institute of Alcohol Abuse and Alcoholism, the National Institute for Child Health and Human Development, Centers for Medicaid and Medicare Services, the Health Resources and Services Administration and the National Institute of Corrections to support research (i) to illuminate the experiences of children of offenders and their families, (ii) to identify the needs, resilience, and protective factors that reduce the involvement of offenders and their children in drugs or criminal activity and (iii) to develop and evaluate models of emotional, social, and economic support for such families;
(b) the Center for Mental Health Services, state mental health agencies, and community mental health centers to place a high priority on the development of services for families of defendants and offenders that not only address the families’ needs but that also mobilize resilience and protective factors in prevention programs;
(c) state and federal courts to strive to ensure that services are available for (i) education of families of defendants about the legal process and (ii) minimization of psychological, social, and economic harm to innocent family members;
(d) social service and health agencies to provide appropriate educational, physical, and mental health services for children of incarcerated parents and their family members,
(e) the U.S. Department of Education and state educational agencies to develop training and other services to strengthen the ability of teachers, counselors, and other school professionals to identify and support children with incarcerated parents and their families;
(f) the relevant federal agencies to develop training programs, including internships, postdoctoral, and continuing education, to increase mental health and social service professionals’ capacity to work effectively with families of offenders;
(g) psychologists and other mental health professionals working in the juvenile and criminal justice system to strive to ensure that attention is given to the needs and potential contributions of offender’s family members.
(h) psychologists and other mental health and social services professionals to provide services to incarcerated parents to strengthen their parenting and employment skills and to assist them as they leave prison and reenter their families and communities.
Abram, K.M., Teplin, L.A., & McClelland, G.M. (2003). Comorbidity of severe psychiatric disorders and substance use disorders among women in jail. American Journal of Psychiatry, 160,1007-1010.
Baunach, P.J. (1985). Mothers in prison. New Brunswick, NJ: Rutgers University Press.
Bernstein, N. (2004, September/October). A bill of rights for children of prisoners. Children’s Voice. Washington, DC: Child Welfare League of America.
Bilchik, S., Seymour, C., & Kreisher, K. (2001, December). Parents in prison. Corrections Today, 63, 108-112.
Family Strengthening Policy Center (2005, September). Supporting families with incarcerated parents. Policy Brief No. 8. Washington, DC: National Human Services Assembly.
Gerard, J.M., Landry-Meyer, L., & Roe, J.G. (2006). Grandparents raising grandchildren: The role of social support in coping with caregiving challenges. Int’l J. Aging and Human Development 62(4), 359-383.
Glaze, L.E. & Palla, S., (2005, November). Probation and parole in the United States, 2004. Bureau of Justice Statistics Bulletin (NCJ210676). Washington, DC: U.S. Department of Justice.
Harrison, P.M., & Beck, A.J. (2005, October). Prisoners in 2004. Bureau of Justice Statistics Bulletin (NCJ 210677). Washington, DC: U.S. Department of Justice.
Harrison, P.M., & Beck, A.J., (2006, May). Prison and jail inmates at midyear 2005. Bureau of Justice Statistics Bulletin (NCJ 213133). Washington, DC: U.S. Department of Justice.
Hughes, T., & Wilson, D.J. (2004, April). Reentry trends in the United States. Washington, DC: Bureau of Justice Statistics (Retrieved October 1, 2006, from http://www.ojp.usdoj.gov/bjs/pub/pdf/reentry.pdf
James, D.J., & Glaze, L.E. (2006, September). Mental health problems of prison and jail inmates. Bureau of Justice Statistics Special Report (NCJ 213600). Washington, DC: U.S. Department of Justice.
Johnston, D. (1995). Effects of parental incarceration. In K. Gabel & D. Johnston (Eds.), Children of incarcerated parents. New York: Lexington Books.
Lamb, H.R., & Weinberger, L.E. (1998). Persons with severe mental illness in jails and prisons: A review. Psychiatric Services 49: 483-492.
Lee, A.F., Genty, P.M., & Laver, M. (2005). The impact of the Adoption and Safe Families Act on children of incarcerated parents. Washington, DC: Child Welfare League of America.
Lewis, D. O., Shanok, S.S., & Balla, D. A. (1979). Parental criminality and medical histories of delinquent children. American Journal of Psychiatry, 136, 288-292.
Mauer, M., Potler, C., & Wolf, R. (1999). Gender and justice: Women , drugs and sentencing policy. Washington, DC: The Sentencing Project.
Parke, R., & Clarke-Stewart, K.A. (2003). Effects of parental incarceration on children. In J. Travis & M. Waul (Eds.), Prisoners once removed, The impact of incarceration and reentry on children, families, and communities. Washington, DC: Urban Institute Press.
The Sentencing Project (2006). New incarceration figures: Thirty-three consecutive years of growth. Washington, DC: The Sentencing Project. Retrieved on September 9, 2006, from http://www.sentencingproject.org/pdfs/1044.pdf
Seymour, C. (1998). Children with parents in prison: Child welfare policy, program, and practice issues. Child Welfare, 77, 469-493.
Travis, J. (2005). But they all come back: Facing the challenges of prisoners reentry. Washington, DC: Urban Institute Press.
Travis, J., McBride, E.C., & Solomon, A.L. (2005). Families left behind: The hidden costs of incarceration and reentry. Washington, DC: Urban Institute.
Travis, J., Solomon, A., & Waul, M. (2001, June). From prison to home: The dimensions and consequences of prisoner reentry. Washington, DC: Urban Institute.
E.(31) Council voted to adopt the following resolution as APA policy:
APA Resolution on Emancipating and Assisting Victims of Human Trafficking (May 2009)
WHEREAS human trafficking has become more widespread in recent years and there are an estimated 12 million affected persons worldwide (although estimates vary from 4 to 27 million; United States Department of State, 2008);
WHEREAS the number of trafficked persons living in the United States is hard to determine, but the Government Accounting Office (2006) estimates that between 14,000 and 17,000 persons are trafficked into the United States every year, and Americans may also financially support human trafficking if they purchase goods made from exploited labor or participate in sex trade tourism;
WHEREAS trafficking can take many forms including labor in factories, farms, or homes, but most of the transnational trafficked persons are forced into prostitution (United States Department of State, 2008);
WHEREAS women (Bryant-Davis, Tillman, Marks, & Smith, 2009) and children (van de Glind & Kooijman, 2008) are disproportionately subjected to trafficking;
WHEREAS human trafficking often involves organized criminal activity (Government Accounting Office, 2006);
WHEREAS, despite gaps in the research literature, trafficked persons who have experienced torture and psychological abuse often require access to human services and treatment of psychological and physical disorders in order to establish the capacity to lead normal lives (Zimmerman et al., 2008);
WHEREAS there is an urgent need to explore the social causes of trafficking, to collect data, and to conduct more research, despite the enormous logistical problems involved in conducting such research;
WHEREAS trafficking violates rudimentary human rights and offends our most cherished values;
WHEREAS the American Psychological Association has taken positions promoting self- determination and dignity for all persons including endorsing rights for women and children, human rights, rights of immigrant workers, and opposition to racism, torture, and to other cruel, inhuman, and degrading treatment and punishment;
BE IT THEREFORE RESOLVED that the American Psychological Association:
Commits itself to promoting public awareness of the presence of human trafficking consistent with its mission;
Commends individuals, nongovernmental organizations, and governments that are working to create public awareness of human trafficking, to prevent human trafficking and to emancipate trafficked persons, and to assist them in obtaining human services and health care including attention to their psychological needs;
Urges funded research on the social and cultural underpinnings of human trafficking, ways to assist trafficked persons, and research into psychological treatments and educational needs for trafficked persons, consist with their unique circumstances; and
Urges the United States government, state and local governments, foreign governments, and international non-governmental organizations to work assiduously to end human trafficking and to assist its victims.
Bryant-Davis, T., Tillman, S., Marks, A., & Smith, K. (2009). Millennium abolitionists: Addressing the sexual trafficking of African women. Beliefs and Values, 1, 69-78.
Government Accounting Office. (2006). Human Trafficking. Washington, DC. Retrieved May 5, 2009 from http://www.gao.gov/new.items/d06825.pdf
United States Department of State. (2008). Trafficking in Persons Report, 2008. Retrieved May 5, 2009 from http://www.state.gov/g/tip/rls/tiprpt/2008/105376.htm.
van de Glind, H., & Kooijmans, J. (2008). Modern-day child slavery. Children and Society, 22, 150-166.
Zimmerman, C., Hossain, M., Yun, K., Gajdadziev, V., Guzun, N., Tchomarova, M., et al. (2008). The health of trafficked women: A study of women entering posttrafficking services in Europe. American Journal of Public Health, 98, 55-59.
F.(32) Council voted to approve the withdrawal of Council New Business Item #25C, “Resolution on
Emancipating and Rehabilitating Enslaved Persons and Prevention of Future Slavery.”
G.(39) Council received an update on the business pending item “APA Resolution to Promote Well-Being and Alleviate Psychological Risk Factors for Immigrants.”
H.(40) Council received an update on the business pending item “Value Neutral Language for End-of-Life Choices.”
XIII. ETHNIC MINORITY AFFAIRS
A.(46) Council received a detailed report of the activities and programs of the CEMRRAT2 Task Force from July 1, 2008 to June 30, 2009.
XIV. INTERNATIONAL AFFAIRS
XV. CENTRAL OFFICE
XVI. FINANCIAL AFFAIRS
A.(33) Council voted to approve the listing of items requiring governance consideration as proposed for 2009 and 2010 as follows:
|Prior Improvements/Cuts Carried Forward to 2010||$1,346,000|
The above actions will be incorporated into the 2010 Budget that will be developed this fall and presented to the Council in February 2010.
William H. Macey, PhD, recused himself from voting on this item.
B.(34) On the recommendation of the Finance Committee and Board, in recognition of the difficult economic climate facing our members, Council voted to approve a one-year suspension for the 2010 dues year of increasing the APA base member dues and the graduate student/teacher affiliate fees by the annual change in CPI.
Council also voted to approve the 2010 revenue projections of $111 million, noting that these revenues will serve as the general framework for the 2010 Budget that will be developed during the fall of 2009 and presented to Council for approval in February of 2010.
C.(47) Council received as information the draft minutes of the June 5 & 6, 2009 Finance Committee Meeting.
D.(48) Council received as information the Argy, Wiltse & Robinson, P.C. 2008 Audited-Related Reports.
On Wednesday morning, Presidential Citations were presented to Randy Phelps, PhD, Kenneth J. Sher, PhD, and Janet K. Swim, PhD.
On Sunday morning, the 2008 Raymond D. Fowler Award – Member – was presented to Ronald E. Fox, PhD, and a Presidential Citation was presented to Ludy T. Benjamin, Jr., PhD.
On Sunday morning, Council paid tribute to the late Jacquelin Goldman, PhD, who had made a gift in her estate to the American Psychological Foundation, of approximately $2 million.
(1) The APA uses the term sexual orientation change efforts to describe all means to change sexual orientation (e.g., behavioral techniques, psychoanalytic techniques, medical approaches, religious and spiritual approaches). This includes those efforts by mental health professionals, lay individuals, including religious professionals, religious leaders, social groups, and other lay networks such as self-help groups.
(2) The Task Force uses the term sexual minority (cf. Ullerstam, 1966; Blumenfeld, 1992; McCarn & Fassinger, 1996) to designate the entire group of individuals who experience significant erotic and romantic attractions to adult members of their own sex, including those who experience attractions to members of both their own and the other sex. This term is used because the Task Force recognizes that not all sexual minority individuals adopt a lesbian, gay, or bisexual identity.