Giving four kids a video game to play together might sound like fun, but Mary Karapetian Alvord, PhD, says it's one of the most challenging sessions her practice offers.

Called Gamesmanship, it's part of a program of social competence training that Alvord developed for children and teens to teach them the skills they need to make and keep friends, including turn-taking and complimenting a competitor on a good shot.

"It's a lot of negotiation, it's cooperation, it's so many different skills," Alvord says.

The program is also a good example of how Alvord has built a successful group practice by developing innovative, evidence-based group interventions and integrating technological advances, says APA President James H. Bray, PhD, who named Alvord as the first recipient of APA's Presidential Innovative Practice Citation. The citation is part of the 2009 Presidential Future of Psychology Practice initiative to recognize groundbreaking practices that may inspire other practitioners. Bray will name 12 winners this year.

Building social skills

Alvord describes social competence as one of the most critical elements to success in life.

"You can be a great student, but if you can't understand reciprocity and flexibility, it's difficult for you to operate on a team for work or on a group project," she says.

In addition to working with children, Alvord brings in parents for the last 15 minutes of a session once a month to teach them how to work with their children on the skills learned and gives them an assignment to practice at home.

"Unless we teach parents, what's an hour going to do?" she asks.

By focusing on social competence, Alvord also helps the children be more resilient in the face of life's hardships, she says. Alvord has been interested in resilience all her life, a pursuit she ties to the example of her parents, whose families fled the Soviet Union to Iran in 1929 and 1932 after Stalin came to power. Then in 1948, her parents immigrated to the United States, four years before she was born. It was the second time they had been thrown into a new culture, but they learned English and thrived. Alvord grew up in Queens, N.Y., speaking Armenian and Russian with her family at home and English with her friends at school.

"Education and hard work were key things in my family," she says.

After earning her psychology doctorate in 1977, Alvord organized a state-funded community mental health clinic for children in Calvert County, Md., then served as director of psychology training at a day and residential mental health treatment program in Montgomery County, Md.

Starting out in some office space lent to her by her children's pediatrician in 1983, Alvord partnered with Patricia Baker, PhD, a clinical social worker and founded a private practice. Alvord, Baker & Associates LLC now has a staff of 11 doctoral-level psychologists and four clinical social workers, located in two offices in Rockville and Silver Spring, Md.

The need for social skills training fueled much of the growth of her practice, which runs 36 groups of six children each, along with offering individual and family therapy for children, adolescents and adults.

The groups include children from kindergarten to middle school. Most stay in a group for at least a year's worth of training.

Intranet and Internet

Alvord's use of technology also helps the clinicians in her practice communicate and keep track of therapy notes electronically. The practice's databases are linked so that therapists can share group-session curricula and quickly find and review a client's case notes. With remote access to their desktops, clinicians can work from home, or from other secured computers.

In addition, twice a month staffers gather in conference rooms with webcams at the Rockville and Silver Spring offices for a peer consultation and staff meeting. Alvord worked with a technology consultant to design a system that would link the two offices, and make it feel like one practice.

"You feel connected if you can see each other and hear each other," says Lisa Sanchez, PhD, a newly licensed practitioner who joined the practice in July.

Alvord also harnessed the Web, creating a site where parents can check a calendar for the group session schedule. If a child misses a group session, Alvord e-mails the parents with homework and reading recommendations.

One reason Bray says he recognized Alvord's practice is because the ideas she is using can be replicated.

"It's applicable all over the United States because [the issues she is addressing] are not problems unique to Maryland and the D.C. area," says Bray. "It's something that children and families face all over the country."

For more information about nominating a psychologist for this award, contact Joan Freund.