Feature

During her fellowship working with Rep. George Miller (D-Calif.), Ruth J. Friedman, PhD, enjoyed the challenge of translating her knowledge into legislation so much that she took a permanent job as the congressman's legislative associate.

"The quick pace of the Hill" feels quite different from conducting research, she says.

That change of pace and the chance to get an insider's view of the U.S. policy process are the reasons many psychologists pursue APA federal policy fellowships. The association has offered fellowships since 1974; this year it adds to its mix the Catherine Acuff Fellowship for midcareer psychologists.

For Friedman, the experience has been the beginning of a new career path. Her fellowship enabled her to work for Rep. Miller and the U.S. House of Representatives Committee on Education and the Workforce, advising Miller and developing and drafting legislation in child care, early education, Head Start, literacy and child abuse. One of her key responsibilities was assisting in the final language for the preschool and kindergarten-to-grade-three literacy programs in the elementary and secondary education bill.

Friedman also took advantage of the fellowship to help, from the policy arena, the children and families about whom she had done her research and clinical work--those living in poverty.

"The fellowship provided the best opportunity for me to gain experience in policy, to learn how psychology could inform policy and to discover what policy opportunities were available to someone with my training," she says.

A unique opportunity

Leonard D. Bates, PhD, the year's William A. Bailey AIDS policy fellow, managed health-care policy for Rep. Donna M. Christian-Christensen (D-Virgin Islands), chair of the Congressional Black Caucus (CBC) Health Braintrust.

He briefed Christian-Christensen on relevant health issues and developed health-related legislation for the CBC. One of Bates' major legislative experiences was with the Universal Health Care Bill, sponsored by Christian-Christensen and Rep. John Conyers (D-Mich.), which encourages the expansion of Medicaid to cover the more than 42 million Americans without health insurance.

He helped mental health care gain equal status to other health needs in the bill, he says. "Being involved in the pro-cess of creating a bill that might become law" was particularly enjoyable, he adds.

Another defining moment of his fellowship was his involvement, within the United States and abroad, in developing HIV/AIDS policy--a unique opportunity, since not many fellows get the opportunity to be the sole individual assigned to help on issues for a representative.

He also enjoyed being able to highlight to members of Congress and federal agencies "the importance of mental health in any congressional attempt to address overall health." Bates believes his fellowship was one of the reasons he was hired as the public policy manager of the National Minority AIDS Council in Washington, D.C.

The 'kid in the candy store'

Health Policy Fellow Terry Cline, PhD, was assigned to the Office of the Associate Director for Organization and Financing within the Center for Mental Health Services at the Substance Abuse and Mental Health Services Admin-istration (SAMHSA). His primary role was to review and make suggestions for policy flowing through the office.

"I was exposed to a great deal of information regarding policy initiatives" of country-wide mental health service organization and financing, says Cline. He relished his position. "Many times I felt like the proverbial kid in the candy store surrounded by a wealth of information."

One of Cline's favorite experiences was with SAMHSA's 1999 state profiles project on public sector managed behavioral health care. As it exposed him to "the public system of care for each of the states and territories," he was "fascinated" with the data and systems for each state as compared with other states.

Now the commissioner for the Oklahoma Department of Mental Health and Substance Abuse Services--responsible for mental health, substance abuse/chemical dependency and domestic violence/sexual assault services in the state--Cline sees the daily impact of federal policy on health-care service providers. "It behooves us as mental health/substance abuse providers to be very involved in [legislative processes]."

A view of the political machinery

Michelle M. Keeney, JD, PhD, now a faculty member at MCP Hahnemann University School of Medicine in Philadelphia, took from her fellowship an appreciation of the "political landscape" and a psychologist's basic role in it: "As social scientists, we need to learn how to communicate our knowledge and research findings in succinct, coherent and relevant ways to influence policy-makers," she says.

Keeney worked for Sen. Edward M. Kennedy (D-Mass.) on the Senate Judiciary Committee's Subcommittee on Immigration as legislative counsel on issues of crime policy and substance abuse. In addition to writing speeches and meeting with constituents, she drafted legislation in the areas of immigration, crime policy, victim rights and substance abuse; she also engaged in negotiations on legislative wording and substantive issues to be included in legislation areas. She enjoyed "seeing the political machinery from the inside and truly understanding how it all works."

Her experiences gave her insight on how to effectively "advocate for legislation and policy." She hopes to use these skills as a policy advocate in the areas of HIV/AIDS and substance abuse, as most of her current patients are dealing with one or both of these concerns.

Policy and practice

For Anna Maria Lucca, PhD, the APA fellowship brought a new reality that directly affected her career path: "I began to appreciate how much policy and financing decisions can shape actual clinical practice," she says.

She worked for the House Ways and Means Health Subcommittee under ranking Democrat Rep. F. "Pete" Stark (D-Calif.), with a strong focus on mental health issues in health-care policy. She advised the congressman on Medicare health policy and analyzed and developed legislation.

Lucca likens what she learned during the fellowship to good, old-fashioned principles of reinforcement: "If you want health-care providers to change the way they practice," she says, "then you have to develop policies and systems that will encourage and support them in providing innovative new services."

One of the defining experiences for Lucca was working with representatives of mental health and aging organizations on the Medicare Mental Health Modernization Act. The bill sought to establish parity for mental and physical illnesses in Medicare and expand beneficiary access to community-based mental health services and qualified mental health professionals. It was "an incredible learning experience trying to balance the interests of different mental health advocacy and professional organizations, while always trying to put beneficiary needs first," she says.

Today Lucca specializes in mental health policy at the Lewin Group, a consulting firm in Falls Church, Va., that helps agencies evaluate their policies and programs.

Working with the White House

Science policy fellow Marguerite E. Malakoff, PhD, applied for the science policy executive branch fellowship, sponsored by APA's science directorate, to get a hands-on sense of what she calls the "true story" of how policy is made within a federal agency.

Her fellowship was with the National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH). Among her duties was assisting G. Reid Lyon, PhD, chief of the Child Development and Behavior Branch and an adviser to the White House on early childhood education, with recommendations regarding the structure of the Head Start program. She also organized a research consultation--a meeting of experts to share ideas and inform the NICHD--with the Office of Prevention in International Programs that took place in Botswana on the care and treatment of HIV-affected women, children and families.

She took away from her fellowship an understanding of "the role and the need for greater presence," she says, of the behavioral sciences at the NIH. These sciences, says Malakoff, need a stronger presence--especially by developmental psychologists.

Now an associate professor of psychology at Randolph-Macon College in Ashland, Va., Malakoff says the fellowship enhanced her teaching, especially in her policy courses. "The fellowship allows me to make discussions of child social policy, policy-related research and the need for research on policy-related issues much more real."