LETTERS

Show me the money!

YOUR LAYOUT STAFF SHOWED a fine sense of irony in the October issue by juxtaposing the report about the scarcity of clinicians interested in a dialogue on treatment of the mentally ill on the flip side of the report about the "enthusiastic" attendance at the symposium for clinicians interested in treatment of the autonomous executive.

What does psychology stand for? Not for the great unwashed--the factory workers who also have work and family problems, and whose low-paying jobs are vanishing overseas. And certainly not for the chronically mentally disabled, whose work histories may be quite ragged.

As millennium fever rises to new fervor, psychologists march to become enmeshed in the grips of an ultra-capitalistic economy, knowing full well that they are participants in a zero-sum game of metaphorical musical chairs, and all too willing to try and grab that last chair for themselves. Apparently the mental health survivors at the dialogue were under the mistaken notion that psychologists would flock to attend an intrinsically interesting event. They were too naive. Even survivors need to take care as to how they market themselves to providers in a capitalist society. Maybe next year they will manifest improved reality testing by focusing on how their needs could better fit the niche psychologists are looking to fill--that with the color of money.

Sharon R. Kahn, PhD
New York City

Monitor-induced depression

IF THE LENGTHY LISTING IN your October issue of those "Honored at APA's Annual Convention" is accurate, I am perhaps the only member of APA who did not receive an award in 1999. This news, combined with the fact that I turned 50 in April, has precipitated a substantial mid-life crisis for me. My teaching has suffered, my desire to conduct research has waned, and I have started breaking out in hives at the most inopportune moments.

In the future, I would encourage the Monitor to consider the side effects of publishing such lists before doing so, or at least to offer crisis intervention services (with a minimal co-pay) to readers who find these announcements anxiety-provoking. It would be a shame if these matters ended up in litigation.

Michael Morris
New Haven, Conn.

I/O psychology

AS INDUSTRIAL/ORGANIZATIONAL psychologists, we were deeply disturbed by the article "Psychology can boost the corporate bottom line." The members of Div. 14 regularly engage in activities that help firms to be competitive, and we realize that clinicians can help organizations as well. But we also believe that psychologists should restrict their practice to areas for which they were trained. This article sends a much different message.

We do not wish to be unfair to the actual panel participants, who did not write the article, and whose views we don't know. Nonetheless, we find the tone of this article offensive. Just as clinicians are highly trained to perform their jobs, we are trained to understand organizations and the behavior of people at work. This training is much more than just "learning the business lingo."

We were especially concerned over the suggestion that clinicians might conduct 360-degree feedback sessions. Someone lacking the proper education might not understand all the issues involved. They might not realize that most organizations use the information obtained for decision making (not just feedback); or that there are problems in weighing evaluations from different sources to make a decision; or that they might run afoul of the Civil Rights Act. This is why clinicians should not conduct these sessions unless supervised by a qualified I/O psychologist.

We resent the implication that someone without adequate training can do what we are trained to do, and we were troubled to see this position in the APA Monitor.

Angelo DeNisi
Nancy Tippins
Elaine Pulakos
Mary Tenopyr
Irwin Goldstein
Janet Barnes-Farrell
Wayne Camara
Neal Schmitt
Div. 14 - (Industrial/Organizational)

APA's stance on ethnic diversity

APA IS MISREPRESENTING the true voice of psychology by pushing on its convention supporters the same stale nonscientific grandstanding on ethnic-diversity issues that we have seen for the past 30 years. The October Monitor article on minorities needing more "support" is logically flawed and preaches its own undeniable brand of racism. The products of such legitimized bias have been flawed research that ignores objectivity in order to "prove" a minority issue, and sound research being swept under the rug in an unrealistic effort not to disturb the facade that all people are equal. Those quoted in the article ask flat-out for special treatment, dual (lower) standards for minorities, and more white guilt. I have seen nothing in the past 30 years of such programs as affirmative action that has significantly advanced anyone. There is no sound scientific evidence indicating that forced acceptance of diversity is better for our society, organizations, or even the minority groups themselves.

Perhaps it is finally time for the patient to help himself or herself. If a group seeks the rewards of a society, any society, then they must join that society's members and live up to the same standards. It is naïve to blame the majority for the failings of the minority. The best defense against racism is excellence, not reverse racism.

Aaron Shaffer
San Diego

A REVISED CODE OF ETHICS is long overdue, but my reading of the Monitor suggests that the new code, expected to be ready for members' comments by 2000, does not augur well for achieving the desired result. The proposed stronger therapist-client sex rule clearly reflects a one-size-fits-all mentality. The absolute ban on post-termination sexual relationships has three major faults: It infantilizes our clients; it fails to take individual differences into account; and it homogenizes the range of diverse therapies into one amorphous unit.

On the first count, the "once-a-patient-always-a-patient" reasoning is based on the unproven assumption that power differentials are a universal truism, and the posited imbalance is not erased with termination. My locale during the past 27 years has exposed me to clients who were prominent professors, powerful executives and eminent attorneys, among others. In most of these instances, the so-called inherent power differentials were reversed, and I had to struggle to achieve personal and therapeutic credibility. The assumption that all clients view their therapists as omnipotent parents was certainly not born out. And with clients who were apt to deify me initially, I usually succeeded in correcting the perceived imbalance before termination.

On the second issue--ignoring individual differences--consider the following scenario: A woman wishes to overcome her fear of flying and receives therapy. After three desensitization sessions the client is no longer airplane phobic, at which point therapy terminates. Some six months later, the ex-client meets her former therapist at a social gathering. They both are single and clearly attracted to each other. They would like to date and get to know each other better. Impermissible!

How can the code of ethics apply the same rule to the aforementioned as they would to people with severe Axis II disorders or frankly psychotic individuals who have not been successfully treated?

Finally, the task force should recognize the diverse range of psychotherapies and realize that what applies to one (e.g., intensive psychodynamic treatment) is completely inapplicable to a different form of therapy (e.g., brief cognitive-behavior therapy). Why is it that one of the first things we learn in Psychology 101 is that we are all unique, and yet when it comes to drawing up ethical codes, it appears we all come from identical molds?

This is not to gainsay the fact that sexual relations with certain former clients may have adverse consequences and carries a substantial risk in some cases. Nevertheless, a total without considering different populations, diagnostic categories, specific problems, duration and type of therapy, seems totalitarian.

Arnold A. Lazarus
Princeton, N.J.

Gaining momentum

AS EVIDENCED BY THE town hall meeting at APA's Annual Convention, the movement to gain prescription privileges has continued to gain momentum, and significant efforts and funds are being used by APA and state psychological associations in order to achieve this goal.

Although it is important for practicing psychologists to be trained in basic psychopharmacology, the pursuit of prescription privileges is a misguided attempt to improve psychology's tenuous position in the current health-care market. As the market's reimbursement patterns have changed, other professions have been able to make significant strides in gaining larger portions of our traditional markets, due in part to our inability to define and differentiate our skills. For our profession to survive we must, at a minimum, be able to distinguish ourselves from other practitioners. However, prescription privileges would only further blur professional boundaries. As it is unlikely that prescription privileges would come without physician oversight, we would become analogous to nurse practitioners and physician assistants who already have such physician-dependent privileges. Rather than increasing status and autonomy for psychology, prescription privileges will likely reduce both.

Since psychology is at an important crossroads facing an uncertain future, our time and resources must not be wasted fighting a lengthy and costly battle that will result in a greater loss of identity. Instead, we must focus our efforts on reinforcing, marketing and lobbying for ownership of the skills that define us as a profession and differentiate us from the already confusing and overcrowded health-care market.

Gregory M. Fliszar, PhD
Pittsburgh

All letters to the editor must be 250 words or fewer. Mail them to APA Monitor, 750 First St., N.E., Washington, DC 20002-4242, or e-mail them.

The Monitor regrets we cannot run all the letters we receive.

APA to Philip Morris: Account for your actions

Psychological studies on the behavioral variables associated with nicotine addiction and tobacco use have found that a variety of factors (e.g., age restrictions, access, advertising, income, culture/ethnicity, and product cost) affect peoples decisions to use tobacco.

APA has also been actively involved in public policy efforts to decrease the rate of tobacco use, as evidenced by the presentation of congressional testimony in support of increased tobacco taxes, scientific contributions to the Surgeon General's reports, the 1996 FDA Rule on restricting youth access to tobacco, and federal advocacy initiatives in concert with other public health groups. With that history in mind, APA took advantage of the opportunity to endorse this letter to the CEO of Philip Morris calling on him to account for his actions.

October 27, 1999

Mr. Geoffrey Bible
Chairman & CEO
Philip Morris Companies
120 Park Avenue
New York, New York

Dear Mr. Bible:

After decades of denial, your company has now acknowledged the overwhelming scientific and medical consensus that cigarette smoking causes lung cancer, heart disease and other serious illnesses, and is addictive. Your public admission brings with it the responsibility for action--not just words--to begin to reduce the more than 400,000 annual deaths from tobacco in the U.S.

Philip Morris also must take responsibility for the fact that more American children, both boys and girls, smoke your Marlboro brand than all other cigarette brands combined, and that Marlboro is the number one cigarette among children worldwide. This is not a coincidence. Your marketing strongly influences children to begin to smoke and in brand selection. Of the more than 3,000 American children who become regular smokers every day, at least 1,800 of them are smoking Marlboro.

Unless you undertake the following important actions to reduce the toll of tobacco, your statements can only be seen as a public relations gesture rather than meaningful corporate change.