Professionally, I am Board Certified in Clinical Health Psychology, and have worked in integrated care throughout my career in multiple contexts including a medical school, hospital, co-location in a physician’s office, and in my own independent practice (since 1994). I work primarily with patients with chronic medical conditions, providing evidence-based psychotherapy and psychological evaluations, to assist them in managing their chronic medical condition and live the most productive life possible given their health challenges. My referrals come from multiple sources including physicians, insurance carriers, case managers, attorneys and self-referrals. I am on most insurance panels, including Medicare, as it is my belief that ALL patients should have access to adequate medical and mental health care. My area of specialty is pain management, and approximately 65 percent of my patients are on long-term opioid therapy. There have been many challenges in my practice over the last year, starting with the CDC Guideline for Prescribing Opioids for Chronic Pain. The clinical practice guidelines were developed to ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse or overdose from these drugs. What they did not present was how to make this happen with the least amount of disruption to the practices and patient care. I have been working with the physicians and patients in having the patients being as functional as possible on the least amount of medications, and using evidence based psychological treatments to manage the pain. There is clearly overlap with the division and the work that I do on a daily basis, including research related to the effects of the medications on behavior, abuse and dependence on opioids and other medications, and policies that have been developed that directly impact my practice.
I have chosen two presidential initiatives: (1) focus on research, education/training and service expansion and inclusion in Integrated Care; and (2) enhancing and ensuring services and education/training and understanding/researching best practices for the Seriously Mentally Ill/Severely Emotionally Disturbed (SMI/SED). It is clear that Division 28 can play a vital role in both initiatives, as there is much overlap with the goals of the initiatives and the central theme of research of Division 28: the use of behavioral principles as they interact with the effects of pharmacological agents and environmental events. I also feel that the contribution of psychological research to our understanding of the seriously mental ill and severely emotionally disturbed has been under-utilized. Division 28 could provide critical expertise to help rectify this situation. I would welcome the expertise of the division as we flesh out the details and further develop the initiatives.