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by Richard Zweig, Ph.D.
This article originally appeared in Clinical Geropsychology News, APA
Division 12 Section II, Fall 2003. Volume 10, No.3.
My exposure to the possibility of successful gero-psychology
education advocacy was serendipitous. In 2002, the APA Education
Directorate's efforts on behalf of psychology training bore fruit;
successful lobbying by Drs. Cynthia Belar and Nina Levitt and their
colleagues resulted in the federal authorization of the Graduate
Psychology Education (GPE) program. For the first time in recent memory,
Psychology would join other health care professions in having the
opportunity to compete for a revenue stream flowing from the US-DHHS
directly to psychology doctoral and internship programs.
Now, I had arrived in the Fall of 2001 in my current
position as Assistant Professor at the Ferkauf Graduate School of Yeshiva
University, and had just begun to build a geriatric psychology
concentration within the Clinical Psychology program. If, prior to
beginning my academic position, someone had predicted that I would find
myself applying for a federal grant during my first year on the job, I
would have responded "which neuroleptic medication did you say you
were taking?" But as serendipity would have it, the listserv
announcement of the call for grant proposals for the US-DHHS GPE program
came in March, promising funding for interdisciplinary graduate psychology
training in work with under-served populations including the elderly. The
timing, while unexpected, could not have been better.
I found myself in the office of my extremely enthusiastic
Dean, Dr. Larry Siegel, wondering how I could seriously pull together the
components of a gero-psychology training program and write an 80 page
proposal in a matter of 6 weeks, and wondering when in the process I might
need to seek some neuroleptic medication for myself. However, with some
prodding and support, I agreed to explore the possibility by taking part
in a DHHS sponsored conference call intended to delineate the elements of
this new program and the grant application process. Fully expecting to be
overwhelmed and intimidated by the process, I did not expect to hear the
DHHS project officer introduce herself by saying "I'm from the
government, and we're here to help you!" Now, being from New York, I
do not think I had ever heard anyone introduce themselves in quite that
way. Needless to say, while still daunted by the prospect of applying for
grant funding, I learned a lot that day, and what seemed an unattainable
fantasy for a fledgling program in a professional school was slowing
becoming a feasible reality.
What were the major lessons learned
along the way about the process of
advocacy and grantsmanship in regard to psychology training?
First, a new idea can be contagious, or to
paraphrase an overused expression, if you try to build it, they will come.
The possibility of a new program generates excitement, or a bandwagon
effect, and as I outlined my sketch for this new program others clamored
aboard. Colleagues who are familiar with grant writing - in my case,
colleagues from the departments of Neurology, Psychiatry, and Internal
Medicine at the Albert Einstein College of Medicine - welcomed me into
their club, and offered their full administrative and material support in
the process, which proved essential. I was also very fortunate to find
other psychologists and students willing to be a part of this new
initiative, and before long, a program began to take shape.
I recognized a second lesson early in this
process. Although very uncertain as to whether my grant application would
succeed, it became apparent that the process of producing an application
already had benefits in regard to the contacts establishedand alliances
forged with other professionals. A new door had clearly been opened, which
had not existed before, and potential opportunities for other
collaborative enterprises were suddenly available.
A third lesson flowed from the earlier ones:
developing a new initiative requires both serendipity and persistence. The
GPE grant application clearly emphasized inter-disciplinary training - the
collaborative involvement of other disciplines to train psychologists -
ideally in a primary care setting. It happened that a week into the grant
application process, a neurologist colleague informed me of a local
director of primary care residency training who was both psychologically
sophisticated and in need of psychosocial resources for his program - in
short, a serendipitous perfect fit. The requirement of persistence became
apparent as I waded through the sometimes incomprehensible grant
application instructions, local bureaucratic hurdles, and other
uncertainties that were at times daunting.
Implicit in all of this is a fourth lesson: when
applying for a grant or developing a new initiative, no prior experience
is necessary. While it is clearly helpful to have the support and counsel
of others experienced in this process, psychologists are well suited to
this endeavor. For example, most of us involved in clinical training have
thought carefully about how to design a training program which is
consistent with the mission of a larger institution, as well as about how
to formulate training objectives, outline methods to achieve them, and
evaluate outcomes of a training program.
A fifth lesson became apparent at the onset of the
grant application process and has continued throughout: Programs built on
a platform of soft money must be maximally flexible and tolerant of
uncertainty in order to survive. It is apparently not unusual to learn of
grant opportunities one month before a deadline, or to hear of grant
funding one month (or even one day) before a program start date. While it
is understandable that many established programs cannot function on such
short notice, the need for maximal flexibility gives an edge to new
programs that are nimble and can rapidly adapt to changing circumstances.
I was extremely fortunate to join with staff and students who were
tolerant of the uncertainties and willing to bend and grow along with a
developing program.
A final critical lesson: Advocacy is an ongoing
enterprise. As you may have heard, the GPE program was dealt a near fatal
blow in June 2003 as a result of a precipitous bureaucratic decision in
Washington. Rather than allowing a new competitive grant renewal process
to proceed, the DHHS- Bureau of Health Professions suddenly allocated all
designated monies to previously un-funded programs, effectively cutting
down the 18 funded GPE programs in their prime. While we could all
appreciate the benefits of funding sound but un-funded programs, no one
anticipated that this would come at the expense of currently funded
programs. Yet what followed was truly remarkable and inspiring.
Undeterred, the 18 GPE programs, led by the APA Education Directorate
staff and Dr. Rick Weinberg of the University of South Florida, mobilized
a grassroots advocacy campaign. The "group of 18" and APA staff
developed a group-sponsored protest letter, contacted state and local
legislators including the chair of the House Appropriations Committee, and
met with Bureau of Health Professions administrative staff in Washington.
Then just a few weeks ago, the unthinkable happened; funding was arranged
to continue all 18 programs, (on a pro-rated basis until Spring 2004), and
the overall GPE grant renewal process was placed on a more sound footing.
Overall then, what have we achieved and learned from this
process? Yeshiva University now has a solid and growing sub-specialty
program that provides interdisciplinary didactic and clinical training in
clinical gero-psychology. We have forged new alliances with the
Departments of Psychiatry, Neurology, and Internal Medicine, expanded from
one training site to three, and discovered new research opportunities for
our students. We have developed an innovative training program that pairs
psychology trainees with internal medicine residents to provide integrated
mental health services to a low income, ethnically diverse population of
older adults seen in a primary care setting. Just as importantly however,
we have learned that a new initiative, when combined with persistence,
serendipity, and ongoing advocacy, can be a powerful force.
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