Return to the Achieves

Presidential Address:
Psychological Interventions in
Long Term Care Residents
Victor Molinari, Ph.D.

       I would like to provide a broad overview of the mental health problems of long term care residents as a backdrop for a specific project that I have proposed to address these needs. Nursing homes can be considered psychiatric institutions (Rovner et al., 1986), with a majority of the residents having a mental disorder and in need of treatment. Over half of the residents have significant cognitive impairment with frequent behavioral problems. It is also estimated that 40% of LTC residents suffer from depression, and 3.5-20% suffer from anxiety. Perhaps only 20% receive adequate treatment because half of the nursing homes don't have access to psychiatrists, and three-fourths don't have access to behavioral consultants (Bartels, Moak & Dums, 2002). Over the last decade, the number of Assisted Living Facilities (ALFs) has increased dramatically, and the ALF market is the fastest growing segment of housing for older adults (Schonfeld, in press). Estimates of mental disorders range from 31%-56 %, less than in nursing homes but still significant figures (Kip, 2000).
       Research with nursing home residents suggest that re-location trauma frequently occurs, with new residents experiencing anxiety, poor morale, depression, and even suicide. Although instrumental burden is reduced for the family caregivers of new nursing home residents, emotional burden often continues, with families not having a well-defined role in nursing home settings. Brook (1989) has defined four transitional stages for new nursing home residents: 1) disorganization (often due to the sequelae of acute medical conditions) where feelings of abandonment and anger predominate; 2) re-organization (residents begin to identify reasons for placement) occurs as the new residents' mental and physical condition gradually improves; 3) relationship-building (the formation of ties to staff and other residents); and 4) stabilization (residents begin to think of the LTC setting as their new home). Family members go through similar stages of adjustment.
       There are surprisingly few well-controlled intervention studies addressing the psychological problems of non-demented LTC residents. I have developed a brief resident/family intervention to ease the transition for new long term care residents. The intervention entails four sessions, the content of which are yoked to the four stages of adjustment discussed above. Pre-post testing and 1, 3, and 6-month follow-ups will be conducted with stress, depression, morale, and QOL measures. Although I have encountered significant recruitment problems, the use of staff members of long stay LTC facilities who are motivated to implement the intervention (with appropriate compensation) may enable me to recruit more effectively. If so, my long range plan is to identify those residents who are most likely to improve, and modify the intervention accordingly for those who don't. Ultimately (and perhaps grandiosely) I would hope to develop a manualized empirically supported treatment program that has good exportability and dissemination potential. I plan to do this by training masters' and perhaps even bachelors' level health professionals to implement the intervention to maximize the likelihood that LTC institutions will have the personnel to begin to view mental health delivery as part of their standard package of services to this most frail and needy group of older adults.
References:
       Bartels, S.J., Moak, G.S., & Dums, A.R. (2002). Mental health services in nursing homes: Models of mental health services in nursing homes: A review of the literature. Psychiatric Services, 53, 1390-1396.
       Brooke, V. (1989). How elders adjust. Geriatric Nursing, 10, 66-68, 126-128.
       Kip, K. (2000). Florida commission on mental health and substance abuse: Data work group report. Tallahassee, Fl.: Florida Legislature.
       Rovner, B.W., Kafonek, S., & Filipp, L., Lucas, M.J., & Folstein, M.F. (1986). Prevalence of mental illness in a community nursing home. American Journal of Psychiatry, 143, 1446-1449.
       Schonfeld, L. (in press). Behavior problems in assisted living facilities. Journal of Applied Gerontology.

President's Column:
Victor Molinari, Ph.D.

       As typical, I have a renewed sense of professional identity after returning from 5 days of camaraderie with fellow geropsychologists in Toronto at the APA convention. I would like to mention just a few of the convention highlights.
       Paula Hartman-Stein, President-elect, chaired two sessions worthy of note: "Prevention and treatment of dementia and depression in older adults" and "Revenue enhancement under Medicare: Coding, documentation, and passing audits." Due to a scheduling conflict, I unfortunately was unable to go to the former session. But I understand that it was well attended (this was particularly impressive since there may have been a 30% drop in registrations for this APA convention given the SARS concerns) and filled with important relevant empirically supportable information on the two most common late life problems. In the second symposium, I became educated about the 'ins and outs' of reimbursements for psychological services. Jim Georgoulakis, Donna Rasin-Waters, and Antonie Puente were real founts of information and provided material relevant to all private practice clinicians. As Jim Georgoulakis noted and Paula reminded me of again afterwards, its amazing that almost all clinicians will be subject to audits at some point in their career. This symposium was a good step towards getting our houses in order to pass the audit with flying colors.
       Another symposium worthy of note was "Mental health service delivery in long term care settings" co-sponsored by Division 12 and chaired by Bob Intrieri. Joe Casciani, Lee Hyer, and Margie Norris combine the best of science and practice, and lent their expertise to an experience-rich discussion of how to competently provide professional services in interdisciplinary LTC settings.
       Robert Kastenbaum, in his inimitable way, gave his Distinguished Contribution to Clinical Geropsychology address "Lillian remembers: an episode on Ward 211" where he integrated art, death studies, and science in a way that only a true Renaissance man of his caliber could muster. Afterwards, as Section II members argued about our interpretations of the meaning of some of his statements, it occurred to me that he is probably quite happy not having a well-agreed upon and standard commentary on his work. Thanks again, Dr. Kastenbaum, for furthering debate and progress in clinical geropsychology over the years.
       In my presidential address on psychological interventions in long term care residents, I outlined the need for mental health services across a variety of different long term care settings, particularly for non-demented residents. I had planned to present some pilot data on a 4-session resident/family intervention to ease the distress for new LTC residents, but ran into recruitment problems. The largely Section II audience graciously assisted me by making a variety of cogent recommendations. I am once again impressed not only with the scientist-practitioner acumen of Section II members, but their willingness to share their knowledge as well.
       Forrest Scogin chaired a very productive conversation hour hosted by CONA that you will be reading more about in the newsletter. Of particular relevance to Section II, we will be beginning a 'President's' call with the various aging stakeholders of APA including CONA, Section II, and Division 20. I heard a number of comments re how CONA has really taken off this year. This is in large part due to the groundbreaking work of the early members, the current impetus of Forrest, Greg Hinrichsen, and Toni Zeiss, and the tireless activity of APA staffer, Debbie DiGilio.
       We also had some very interesting discussions at the Business and Executive meetings. The Guidelines for Psychological Practice with Older Adults, which many Section II and Division 20 interdivisional task force members have been laboring with for so long, has been approved without a hitch (this time). We all know that this could not have happened without the vision, forward thinking, and perseverance of George Niederehe, and I gratefully thank him for his low-key but tenacious efforts. This rite of passage also triggered a discussion of what direction Section II should now take. Since APA has nixed the idea of a proficiency credential for clinical geropsychology, seeking specialty status for clinical geropsychology is an idea whose time has come. It was agreed that we would collaborate with Bob Knight who has agreed to spearhead this project in his role as president of Division 20. Once we get APA specialty status secured, we will re-open the debate concerning acquisition of ABPP status, which as Steve Sohnle (Chair of the ABPP exploratory committee) documented, will be a more prolonged, expensive, and labor-intensive process that ultimately may bear great fruit. Just to mention also the fine job that Margie Norris has been doing as Chair of the Public Policy committee. Margie's missives to our members are a real informational pipeline re practitioner relevant issues that clinicians so welcome.
       Finally, a special note of appreciation to Paula Hartman-Stein and Peter Lichtenberg for the great social night that they hosted for us at Café Sassafraz, an upscale club that now counts Division 20 and Section II members among their celebrity clientele!

Summary of 12-II : Board of Directors Meeting
Forrest Scogin, Ph.D.

The meeting was called to order by Victor Molinari at 4:20 PM. In attendance were V. Molinari, S. Qualls, M. Arnold, D. King, P. Hartman-Stein, M. Norris, G. Niederehe, S. Sohnle, and R. Intrieri.

Secretary Report. Forrest Scogin submitted the minutes from the 2002 Executive Board Meeting, prepared by last year's secretary Barry Edelstein. They were approved as written.

Treasuer Report. Margie Norris distributed a report indicating a current balance of over $10,000. She suggested proposals be developed to tap into this healthy budget. Sara proposed that due to the higher costs associated with travel to APA 2004 that we consider using funds to help our student representatives attend.

Elections/Amedment Results. Sara Qualls reported the election results. Barry Edelstein was elected President-Elect and Deborah King was elected as Section II's representative to the Division 12 Board. The proposed amendment to membership bylaws to exclude the requirement that Section 2 members also hold membership in the American Psychological Association was defeated by vote of section members.

Division 12 Board Representative Report. Deborah King distributed a report detailing the business and executive board meetings of Division 12. There followed a more detailed discussion of Division 12's interest in developing a more active public policy agenda. It was agreed by those in attendance that aging should have input to these efforts. A position paper will be developed by Deborah, Bob, and Margie to be submitted at October meeting of the Division 12 Board. In part, this will serve to educate Division 12 about public policy efforts. Examples of public policy efforts from our section can be provided to further understanding.

Membership Committee. Robert Intrieri reported that Section II has five new student members and eight new members. We have not been able to determine total membership figures. Bob and Forrest will work on this post APA.

Newsletter. Merla Arnold. Merla reported that newsletters were depleted rapidly from the Division 12 booth at APA suggesting an interest in the activities of Section II. A suggestion was made to distribute newsletters and membership forms at aging symposia conducted at APA/GSA and have more available at Division 12 booth. Merla requested input for the upcoming issue of the newsletter and reminded those with commitments on the approaching deadline.

Program Committee. Paula Hartman-Stein reported that the two symposia she organized for Section II were well-attended and deemed successes. The Division 20/Division 12, Section II social event was discussed, more specifically the pros/cons of doing a joint event. The question arose as to how the event was viewed by Division 20 members. President-elect Barry Edelstein will be asked to contact Division 20 leadership to get their reaction and make future plans. The consensus was that doing something jointly was desirable but the particular forum for doing so is not clear. It was agreed that more opportunity for informal interaction would be desirable.

Office on Aging/Committe on Aging Report. Deborah DiGilio & Diane Elmore distributed a newsletter a distributed providing an update on the various activities of the Office. Debbie learned from the Division 40 (Neuropsychology) program chair that they will focus on aging issues during the 2004 APA convention. It was suggested that President-elect Barry Edelstein should contact them to create Division 40/Division 12, Section II collaborative programs for APA 2004. Diane Elmore, SPSSI Public Policy Scholar, updated the board on public policy efforts through the Office on Aging. Efforts have been undertaken to create a greater aging presence in the Public Policy Office of APA. Diane discussed efforts on the Positive Aging Act to be inclusive of psychology. Debbie and Diane also reviewed the process involved in presenting congressional testimony and stressed the importance of this activity for the advancement of aging issues. The Executive Board expressed thanks for the hard work of the Office on Aging.

Practice Guidlines Committee. George Niederehe reported that the Guidelines were passed without controversy by the Council of Representatives. George was congratulated for his efforts on this project. These guidelines will be in effect for seven years. They will be posted on the APA website in the next month or so. George will also pursue publication in the American Psychologist. Further dissemination ideas included a piece in the APA Monitor, links on state psychological association websites, and articles in various newsletters. In the process of making the guidelines acceptable to APA governance, parts of the document related to training models in geropsychology were deleted. George indicated he will try to get this information published in a journal such as Professional Psychology.

Specialty/ABPP Application. Victor Molinari & Steve Sohnle reported that a working group (Bob Knight, Greg Hinrichsen, Victor Molinari, Toni Zeiss, Paula Hartman-Stein, and Forrest Scogin) met at APA to discuss the wisdom and process of pursuing clinical geropsychology as a specialty. Bob Knight has agreed to spearhead this effort. In a related vein, Steve Sohnle submitted a report on the steps involved in pursuing ABBP status for clinical geropsychology. At best this is a 2-3 year process and will involve a financial commitment. Victor suggested that pursuing specialty status through APA may be the more prudent first step. Concern was expressed that specialty status may deter some psychologists from aging service provision. It was suggested that the committee investigating specialty status should carefully consider the ramifications of this move to the field. Sara Qualls made a motion for the Board to approve the proposal by the President of the section (Victor) to work with Division 20 President Knight to develop an application for recognition of clinical geropsychology as a specialty. The motion was approved.

Public Policy Committee. Margie Norris distributed a report on the committee's activities. She discussed the need for continued vigilance regarding Medicare policy, particularly Local Medical Review Policies that serve as models for other carriers. Margie expressed interest in someone assuming the chair of the Public Policy Committee, a role she has occupied since 1997. President-elect Paula Hartman-Stein will contact potential candidates.

Continuing Education Committee. Victor Molinari will follow-up on finding a new chair for this committee.

Committee on Aging Application. Sara Qualls moved that the board provide letters of support for the applications of Barry Edelstein and Victor Molinari. The motion was passed. Sara will prepare the letters. Discussion ensued on how best to include diverse candidates for future CONA slates.

The meeting was adjourned at 6:30.

CONA & Office on Aging Update
Diane Elmore, PhD, SPSSI; James Marshall, Public Policy Scholar; Deborah DiGilio, MPH, APA Office on Aging; Forrest Scogin, PhD, Chair, APA Committee on Aging

       In past columns, we have provided overall updates on the activities of the APA Committee on Aging (CONA) and the Office on Aging. In this issue, we would like to highlight our aging policy efforts in collaboration with the APA Public Policy Office. These collaborative policy endeavors began approximately two years ago with a team including members of CONA; Deborah DiGilio, MPH, Office on Aging; and Nina Levitt, EdD, Director of Education Policy in the Public Policy Office (PPO). In September 2002, Diane Elmore, PhD, SPSSI James Marshall Public Policy Scholar, joined PPO's Public Interest Policy staff for a two-year appointment in which part of her time is dedicated to aging policy at the federal level. This growing "APA aging policy team" works collaboratively to ensure that psychology's contributions to the health and well-being of older adults are recognized in all aspects of the policy arena.
       The Graduate Geropsychology Education initiative has been spearheaded by Nina Levitt. With the assistance of CONA and other geropsychology advocates, a dedicated funding stream of $1.5 million for geropsychology was established within the Graduate Psychology Education (GPE) Program in the Bureau of Health Professions beginning in 2003.
       The Positive Aging Act (H.R. 2241/S.1456), as reported in the last newsletter, was introduced on May 22 by Representatives Patrick J. Kennedy (D-RI) and Steny H. Hoyer (D-MD), Democratic Whip of the House of Representatives. Senator John Breaux (D-LA) introduced a companion bill in the Senate on July 25. This legislation is designed to enhance access to vital mental health services for older Americans through mental health outreach to primary care and community-based settings. CONA members, the APA Public Policy Office and Office on Aging worked with Representative Kennedy's office and the American Association of Geriatric Psychiatry (AAGP) to successfully modify the original bill to provide an interdisciplinary model of health care for older adults that is inclusive of psychology.
       The Elder Justice Act (S.333/H.R. 2490) was introduced in the Senate on February 10 by Senator John Breaux (D-LA), while a companion bill was introduced in the House of Representatives on June 17 by Rep. Rahm Emanuel (D-IL) and co-sponsors, Rep. Peter King (R-NY) and House Majority Whip, Roy Blunt (R-MO). The bill, as introduced, inadvertently omitted "psychologists" from a list of health care professionals eligible for training through grants awarded as part of the legislation. In April, our aging policy team met with Senator Breaux's office and successfully requested that a technical amendment be made to include psychologists in this section. The bill's provisions include: 1) providing national attention and resources for elder justice issues; 2) improving the quality, quantity and accessibility of information on abuse, neglect and exploitation; 3) increasing research and resources on elder abuse issues; 4) developing forensic capacity for police and investigators; and
5) expanding and enhancing training.
       "Senior Depression: Life-Saving Mental Health Treatments for Older Americans" was the topic of a congressional hearing on July 28 by Senator John Breaux (D-LA) of the Senate Special Committee on Aging. Senators Elizabeth Dole (R-NC) and Harry Reid (D-NV) were also in attendance at this committee's first hearing since 1996 that specifically focused on mental health and aging issues. The expert panel included two APA members: Donna Cohen, Ph.D., Department of Aging and Mental Health, University of South Florida, and Jane Pearson, Ph.D., Associate Director for Preventive Interventions at the National Institute of Mental Health. The Public Policy Office extended support to both of these psychologists in the weeks prior to the hearing. In particular, we worked closely with Dr. Cohen throughout the process by sharing APA aging policy resources, holding a briefing luncheon before the hearing, and delivering her testimony to Senator Breaux's office. In addition, our team recommended an additional panelist, Ms. Hikmah Gardiner, an older adult mental health consumer from Pennsylvania, who was included on the panel by Senator Breaux's staff.
       "Providing Lifespan Respite Care: Vital Support for Family Caregivers" was the title of a congressional briefing on July 30, cosponsored by APA and the National Lifespan Respite Care Task Force. The panelists included Congressman Dennis Byars (R-NE), three family caregivers, and APA member William Haley, PhD. Although Dr. Haley's presentation, "Family Caregiving: What the Research Says" was scientific in focus, he presented the information in a way that engaged the audience with its relevance to their lives.
       "Ageism in the Health Care System: Short Shrifting Seniors?" was the subject of a May 19 congressional hearing of the Senate Special Committee on Aging chaired by Senator Larry Craig (R-ID). This hearing, which received national media attention, focused on ageism primarily from a medical perspective. Little focus was directed to mental health overall, and the contributions of psychological research and practice were neglected. Therefore, our aging policy team worked to promote the contributions of psychology on issues of ageism by submitting written testimony related to ageism that was included in the public record of the hearing, and provided relevant resources from the psychological community to the offices of Committee Chairman Craig and ranking member Breaux, including the book edited by Todd Nelson, Ph.D., Ageism: Stereotyping and Prejudice Against Older Persons, the May APA Monitor article entitled, "Fighting Ageism" and the APA Council of Representatives Resolution on Ageism.
       Development of Policy Materials. To facilitate our continued interactions with members of Congress, the Public Policy Office and Office on Aging are developing a brochure for policy-makers that highlights psychology's contribution through research and practice to the health and well-being of older adults. The Office on Aging has received funing from the Retirement Research Foundation to develop this professionally designed brochure. In addition, fact sheets on important aging issues are being developed and made available to congressional offices, individuals and groups interested in aging advocacy, and to psychologists and the general public through the APA Office on Aging web page. Recent fact sheet topics include depression and older adults, suicide and older adults, mental health and aging policy issues and recommendations, and the contributions of psychology to the health and well being of older adults.
       The Public Policy Office works along with the APA Government Relations Office in the Practice Directorate to: inform Congress about psychology and its relevance to federal policy; advocate for increased support for federally-funded psychological research and behavioral and mental health services; strengthen the voice of psychology at the regulatory level; advance opportunities for the education and training of psychologists; and combine the expertise of psychologists to address the many challenges facing our nation.
       How Can Psychologists Interested in Aging Issues Become Involved? The Public Policy Office and the Office on Aging welcome your assistance with activities including: drafting and reviewing aging legislation; participating in interdisciplinary discussions/meetings on policy issues; presenting at congressional briefings and hearings; meeting with members of Congress locally and in Washington, D.C.; serving as an informational resource for APA and congressional staff and acting as a media resource on aging issues.
       If you are interested in being included in our database of persons who are interested in collaborating with APA on aging policy issues or to learn more about aging policy issues, please contact: Diane Elmore, Ph.D., in APA's Public Policy Office at delmore@apa.org, or Deborah DiGilio, MPH, in APA's Office on Aging at ddigilio@apa.org.

Public Policy Committee Update
Margie Norris, PhD

       The APA Clinical Geropsychology Section's Public Policy Committee (PPC) expanded the mission statement. Goals and action items were added with the hope that the additional focus will help others understand the projects the committee engages in on behalf of Section II, in addition to aiding the PPC with our efforts.
       If you have any comments or questions, please feel free to contact me or any of our committee members including Jiska Cohen-Mansfield, Natalie Denburg, Paula Hartman-Stein, Bob Intieri, Brad Karlin, Brian Kaskie, David Powers, Stephanie Scheck, and Lynn Snow.

Mission Statement: The mission of the Public Policy Committee of APA's Division 12, Section II is to promote greater awareness of and responsibility for the need for competent and ethical psychological services for older adults in all geriatric care settings including medical, long-term care, community and private sector settings. The committee will serve as a link between geropsychologists, geriatric mental health organizations, and the public and private health industries to advocate on behalf of policies that promote high quality mental health services for all older adults.
Goals and Action Items.
Goals and Action Items:
        Goal I. Disseminate information to members of Section II regarding public and private policy changes impacting geropsychology practice, training, and research, and to recommend to Section II members appropriate advocacy activities that are proactive toward meeting the mental health needs of older adults. Actions: 1) Use the Section II listserv to educate and update members on issues pertaining to mental health access for older adults. 2) Inform Division 12/Section II members of letters that should be written in response to upcoming bills and policies. 3) Distribute updates to the APA Interdivisional Geropsychology Coalition. 4) Distribute website addresses that will assist members in their knowledge about policy matters and their advocacy efforts.
       Goal II. Monitor legislative and regulatory policy changes that influence accessibility of mental health services to older adults through Medicare and private sector mental health insurance systems. Actions: 1) Maintain representation on the APA Medicare Task Force. 2) Stay abreast of upcoming and current OIG reports and submit comments to the OIG. 3) Monitor federal legislature pertaining to mental health access for older adults.
       Goal III. Function as a liaison to numerous professional organizations that influence mental health policy, and are impacted by mental health policy. Inform and educate liaison organizations about the science and practice of geropsychology for the ultimate purpose of coordinating advocacy efforts, increasing awareness, and promoting accessibility of competent geriatric mental health services. Actions: 1) Participate in the CMS Open Door Meetings for Allied Health Professionals and Skilled Nursing Homes; distribute notes to the Section members. 2) Communicate regularly with APA's Committee on Aging (CONA) to coordinate advocacy efforts. 3) Communicate regularly with Psychologists in Long Term Care (PLTC) to coordinate advocacy efforts. 4) Communicate regularly with National Coalition for Mental Health and Aging (NCMHA) to coordinate advocacy efforts.
       Goal IV. Bring accurate scientific knowledge about aging and mental illness to public and private sector policy makers (e.g., state and federal health care agencies, CMS and Medicare carriers, private insurance corporations), and alert policy makers when existing or proposed policies present barriers to older adults' access to quality mental health care. Actions: 1) Monitor new draft LMRPs pertaining to psychology services. 2) Oversee comment letters in response to new LMRPs, CMS policy, and state Medicaid policies. 3) Maintain list of individuals willing to provide testimony at federal and state government hearings on issues related to mental health and aging.

APA Convention Programing Emphasizes Integration of Science and Practice
Paula Hartman-Stein, PhD

       Division 12, Section II sponsored two well-attended symposia at the 2003 APA convention that linked the science and practice of geropsychology. Forrest Scogin, Ph.D. led off the first symposia with an excellent summary of evidence-based practice models for the treatment of depression in older adults. He stressed that psychological treatments for depression are strong medicine, and many older adults prefer psychosocial interventions to medication only protocols. He concluded that psychologists can provide state-of-the art evidence-based treatments alone or more realistically and efficaciously in combination with pharmacotherapy.
       Robert Wilson, Ph.D. reviewed recent findings from a series of longitudinal studies involving cognitive activity and its impact on Alzheimer's disease. More frequent cognitive activity was associated with reduced cognitive decline in persons without dementia but with more rapid decline in individuals who already have symptoms of Alzheimer's disease, suggesting that cognitive activity delays the onset of the clinical manifestations of the disease. Once Alzheimer's disease is evident, however, the protective effect appears to diminish.
       Michael Marsiske, Ph.D. reviewed findings from the ACTIVE studies demonstrating that durable training gains for multiple cognitive areas are achievable with older adults. However, the consistent specificity of training effects remains a challenge for translating cognitive enhancement into real world benefits.
       Transfer of gains is most likely when there is a strong resemblance between the target of training & every day outcomes. Cognitive enhancement strategies for older adults may fit best into a primary prevention model.
       In the second symposium, Revenue enhancement under Medicare, James Georgoulakis, Ph.D. provided a riveting presentation emphasizing the need for psychologists to understand correct CPT coding, the concept of medical necessity, and the need for thorough documentation when billing Medicare, even if they work for an agency or group practice, or risk possible fines and criminal prosecution. Proper CPT coding can also increase revenue, as statistics from the Center for Medicare and Medicaid Services show that providers receive only between 60 to 80% of the revenue they are entitled to receive.
       Donna Rasin-Waters, Ph.D. presented a model of voluntary compliance that she developed for solo practitioners to catch mistakes when billing under the Medicare system.
       Discussant Tony Puente, Ph.D. described the long, painful process of a Medicare audit that he experienced and reinforced the recommendations made by the presenters.
       Victor Molinari, Ph.D. delivered a thoughtful and interactive presidential address that described his current research efforts in the long-term care field. Members of the audience provided pragmatic suggestions for enhancing the enrollment of more subjects in his research.
       For the first time at an APA convention Division 20 and Section II combined their annual social events. About 80 people attended a cocktail hour followed by an elegant dinner at Café Sassafras, a four-star posh restaurant in Yorkville. During the dinner we surprised Section II award winner, Robert Kastenbaum, with a traditional cake and song to celebrate his birthday.
       Despite the low numbers of attendees overall at the 2003 convention, the field of geropsychology appeared to be well represented in Toronto.

Section II Awards:
William Haley, PhD, Chair

Lawton Award fo Distinguished Cotnributions to Clinical Geropsychology:
Robert Kastenbaum, Ph.D.
Arizona State University
The following is contributed by Gregory Hinrichsen.
       In conjunction with his receipt of the Lawton award, Robert Kastenbaum, Ph.D. gave a presentation at the 2003 APA Convention, "Lillian remembers: An episode on Ward 211." Drawn from Dr. Kastenbaum's professional experience as director of the Cushing Hospital for the Aged, the presentation raised provocative questions about frailty and aging as well as the professions and institutions designed to assist the frail and aged. These are themes that are woven into the career of one of the very first clinical geropsychologists.
       Dr. Kastenbaum has held major academic positions including those at Wayne State University, The University of Massachusetts-Boston, and Arizona State University from which he retired and at which he is Emeritus Professor. Major areas of scholarly emphasis in his career include gerontology, life-span development, and dying/death/grief/suicide. He was editor of both the International Journal of Aging and Human Development as well as Omega, Journal of Death and Dying for almost 20 years. Former President of the American Association of Suicidology, GSA's Behavioral and Social Sciences section, and APA's Division 20, he is the recipient of numerous awards and honors. A recent award was GSA's Richard A. Kalish Award for Most Innovative Publication for his book, Dorian Graying, which also formed the libretto of an opera.
       A walk through Dr. Kastenbaum's many publications and their provocative titles tells part of the story of this remarkable career. 1963: "The reluctant therapist" in Geriatrics; 1966: "The mental life of dying patients"; 1967: "aged?"; 1989: "Old men created by young artists: Time transcendence in Tennyson & Picasso"; 1992: "Let's stay on speaking terms about death and dying"; 1995: "Cookies baking, coffee brewing: Toward a contextual theory of dying."
       In addition to the libretto for Dorian, he has written other libretti and plays. "Tell Me About Tigers" is play based on the real life experiences of a suicidologist who returned to his apartment for the last time to prepare gifts for his friends before dying.
       It premiered in English and French versions in Montreal. "High Time" was a short piece exploring the relationship between two elderly women, one of whom was still voluntarily housebound after the death of her husband. As is evident, Robert Kastenbaum remains an active and creative force both within gerontology and outside of it. We are honored to have him in our ranks.

Division 12, Section II Distinguished Mentorship Award:
Gregory Hinrichsen, Ph.D.
The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System
The following is contributed by William E. Haley, Ph.D.
       The purpose of this award is to recognize clinical geropsychologists who have played important roles in the clinical supervision of psychology graduate students, interns, and/or postdoctoral fellows who provide services to older adults. It also recognizes individuals who have played mentoring roles for graduate students, interns, and fellows interested in a career in clinical geropsychology.
I have long been familiar with Dr. Hinrichsen's many contributions to our field, including his scholarly and professional writing, his service in compiling the section's internship and postdoctoral fellowship directories, and his leadership efforts. Upon reading the seven letters supporting Dr. Hinrichsen for this award, I was even more impressed with the impact that he has made on a cadre of interns and fellows. Comments from the letters include:
      • "I believe his mentorship as a teacher, clinician, and person has made an enormous positive           difference in my professional growth and development."
       •"He is a rare psychologist who truly models a scientist approach to his work…In the seven plus           years since I completed my postdoctoral training with Greg, he has remained an important           mentor to me."
       •"He has been tireless in his efforts to assist in the development of my professional identity as a           geropsychologist and active member of the professional community."
       •"I am in no doubt that my career path owes a great debt to his input, inspiration, and advocacy."

Congratulations to Greg for this well-deserved recognition!

Division 12, Section II Student Research Award:
Tara L. Victor, M.A.
Michigan State University

The Role of Executive Function as a Mediator of Age-related Differences
in Free Recall Memory Performance.

       The elderly are the fastest growing segment of the U.S. population, yet the effects of aging on this groups' cognitive function are not well-known or sufficiently understood.
This is coupled with the fact that this age group is vulnerable to increasing disabilities, many of which are the result of the aging central nervous system. Thus, as the number of older adults continues to increase, so does the importance of understanding the cognitive aging process. Being able to identify those cognitive elements that seem to characterize the mental status of elderly populations is very important to our understanding of this process and has major implications for the adaptive functioning and overall psychological health of these individuals.
       One particular area of cognition that declines with age is memory. Much research has focused on age-related memory decline; however, there are many questions still left unanswered. The purpose of this study was to elucidate the mechanisms through which age exerts its effects on memory performance. Specifically, this study investigated the hypothesis that executive function (the class of cognitive abilities thought to encompass the wide range of mental processes involved in problem solving, such as planning, strategic and abstract thinking, self-monitoring, shifting tasks and behavioral inhibition), processing speed (how quickly one can think and process information) and working memory (the ability to store and manipulate information simultaneously) would all mediate the relationship between age and free-recall memory performance. A focus was placed on the role of executive function. In addition, exploratory analyses concerning the relative contributions of different aspects of executive function (i.e. attention, response inhibition and set-shifting) to the age-memory relationship were conducted.
       A total of 241 adults participated in this study ranging in age from 54-87 years (M = 68.97, SD = 7.8). All participants were home-dwelling community elderly individuals recruited through local newspaper advertisements and talks given to local community groups. Exclusion criteria included evidence of depression or significant gross cognitive impairment to ensure that the sample examined was representative of the normal aging population. This yielded a total sample of 210 (118 females). Finally, each participant was offered the opportunity to participate in memory and attention training workshops as a result of participating in the study. Variables were measured using standard neuropsychological tests (i.e. California Verbal Learning Test, Wisconsin Card Sorting Test, Trailmaking Test, Stroop Test, Symbol Digit Modalities Test, WMS-III Digit Span Backwards) with a sample of normal healthy elderly individuals. Hierarchical multiple regressions indicated that age (54-87) contributed only 8.8% to the variance in memory performance. Both executive function and processing speed when entered alone partially mediated the relationship between age and memory. When entered together, they fully mediated the relationship. Working memory was not found to be related to free-recall memory performance. All three aspects of executive function contributed similar amounts to the age-related variance. These results were discussed in light of their practical, theoretical and methodological implications.

Eye on Education and Training :
Susanne Meeks, Ph.D.

       Clinical Geropsychology Training at the University of Louisville. The faculty of the Ph.D. program in Clinical Psychology at the University of Louisville are pleased to announce their newly-developed program concentration in Clinical Geropsychology. The University of Louisville clinical program offers strong, generalist training from a research-oriented scientist-practitioner model. The program uses an apprenticeship model for research training wherein students apply to work with specific faculty members. There are two core faculty members accepting students in clinical geropsychology: Drs. Benjamin Mast and Suzanne Meeks, whose research interests are described below. In addition to these faculty members, several others provide support to students with a gerontology interest. Dr. Stan Murrell has published extensively in the area of stress, health, depression, and aging, and is available to support student research in these areas. Dr. Murrell is well known in the aging field for his research with a large, representative, prospective sample of older Kentuckians; students and faculty of the department have benefited greatly from the availability of this data set, and opportunities continue for students to make use of these archived data. Faculty members in the area of psychopathology (Drs. Janet Woodruff-Borden and Richard Lewine), and in the area of health psychology (Drs. Tamara Newton, Paul Salmon, and Barbara Stetson) also have interests which integrate with or augment aging interests.
       Curriculum. In addition to the generalist core training, graduate students in clinical geropsychology will complete a seminar series on clinical issues in aging, and a course in neuropsychological assessment. An additional seminar in health psychology is also recommended, although other alternatives can be organized in consultation with the mentor to suit an individual student's interests and career goals. Research and clinical opportunities are described below. Students are required to complete a Master's Portfolio that encourages collaborative research with the faculty mentor and students with similar interests.
       Research Opportunities. Students working with Dr. Mast may become involved in research concerning late life depression and dementia, including research addressing the vascular depression hypothesis in late life, assessment and treatment of post-stroke depression, and links between late life depression and dementia. Students working with Dr. Meeks will be involved in funded research concerning evaluation of a behavioral treatment for depression in nursing homes. Related interests include understanding the role of positive affect and activity in depression; students also may collaborate on analyzing data related to adaptation of older adults with severe mental illnesses. Students are also encouraged to pursue their specific interests related to ongoing research programs. For information on specific research programs and recent publications, visit Dr. Meeks' web site at http://www.louisville.edu/~s0meek01, or contact Dr. Mast at b.mast@louisville.edu.
       Clinical Opportunities. Students in the University of Louisville Clinical Psychology program receive their primary clinical training through our Psychological Services Center (PSC), where students provide assessment and psychotherapy services. As a part of that training, students may rotate through several supervision teams with varying foci. The PSC serves the community at large, and as such elderly clients are seen either in the PSC or through local agencies or nursing homes with whom the PSC has relationships. Additionally, geropsychology students may complete their required outside assessment practicum at one of 2 local neuropsychology practices or psychiatric hospital. Paid clinical assistantships in the geriatric unit or a local neuropsychology practice are also available. These opportunities, in combination with a solid grounding in basic clinical geropsychology and neuropsychology offered in course work, provide a broad basic training that makes our students very competitive for top gerontology internship settings.

GPE FUNDING: Lessons Learned
Richard Zweig, Ph.D.

       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 grass roots 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.

QUESTIONS for members ....
Should NON-APA/NON-Division 12 Members be allowed to become Section II members if they meet all other Section II qualifications???
This proposal was discussed by the Executive Committee and is seen as a means to broaden and strengthen Section II membership roles. There will be a formal ballot vote by Section II members after a comment period. Please address your comments concerning this Proposition to Victor Molinari, Ph.D. at: vmolinari@fmhi.usf.edu and/or on the listserve at: WVUGER-L@LISTSERV.WVU.EDU

TO SEEK OR NOT TO SEEK ABPP STATUS ???
Would you seek ABPP clinical geropsychology specialty status if one were available? Please address your comments concerning this Proposition to Victor Molinari, Ph.D. at: vmolinari@fmhi.usf.edu and/or on the listserve at: WVUGER-L@LISTSERV.WVU.EDU

Editor Comments:
Michelle Gagnon, Psy.D.
Merla Arnold, R.N., Ph.D.

This is the first issue of a two-issue transformation of editorship from Michelle (Shelley) Gagnon to Merla Arnold. We will be working collaboratively on this and the Summer 2003 issues. Please forward any comments or suggestions to either Shelley (Mgagnon123@aol.com) or Merla (ma159@columbia.edu). As always, we appreciate the input of Section II members.

Prior to becoming Coeditor of Clinical Geropsychology News, Merla served as a Student Representative for Section II. The position provided a wonderful opportunity to participate in the work of the Section, on behalf of student members, while learning about the many issues that impact the work of clinical geropsychologists and students in clinical geropsychology. It is both a challenging and exciting time for the Section and the profession at large, as the articles within this issue attest. In this complicated health care environment, the sharing of ideas and information is as important as ever. As such, there is a strong commitment to maintain the Clinical Geropsychology News as an effective communication tool among Section II members.

Membership renewal notices will be mailed to Section II members in January. If you have any concerns, please contact Michele Karel (Michele.Karel@med.va.gov). New Membership applications will be included in this mailing. Please encourage students and colleagues to join Section II. As it has been said, there is strength in numbers.

An opportunity: If you would like to present your clinical geropsychology training site/educational program to Section II members via this Newsletter contact Merla Arnold, R.N., Ph.D. at: ma159@columbia.edu

       Fellowships, sponsored by the National Institute on Aging, are for 1 to 3 years and are designed to train psychologists for academic and research careers in the psychology of aging. Fellows carry out their own research under the supervision of a faculty preceptor. Current faculty interests related to the clinical psychology of aging include neuropsychology, neuroimaging, dementia, interventions for memory complaints in healthy older people, coping with hearing handicap, family relations and decision making, end of life issues, interventions in long-term-care settings, and personality disorders in later life. Prior training in aging is not required. Fellows must be citizens, noncitizen nationals, or permanent residents of the United States.
       Send curriculum vitae and three letters of reference to Martha Storandt, Ph.D., Department of Psychology (Box 1125), Washington University, 1 Brookings Drive, St. Louis, MO 63130-4899. Phone: 314-935-6508. FAX: 314-935-7588. Email: mstorand@artsci.wustl.edu . Review will begin in January, 2004.
       Washington University is an equal opportunity/affirmative action employer. Employment eligibility verification required.

       As I begin my second year in a doctoral program and begin seeing clients, I am struck by the need for efficacious treatments and the ethical obligation all clinicians have to provide the best treatment for the individual client. As I meet with each of my new clients, I am amazed at how different they are, not only in terms of diagnosis but in what I believe to be the reasons for their problems and why they have decided to seek treatment. In realizing these differences I recognize the enormousness of the task in front of me, selecting the treatment I believe will be the most helpful and most effective for that individual.
       In discussing my clients with my supervisor, I begin to think about the evidence-base of the treatments available. I am in awe of the research and addressing the parts of treatment that make the treatment effective and for whom. Yet, still I am surprised at the articles I find that show popular treatments to be ineffective, or that lack an evidence base regarding effectiveness. I have noticed an absence of measurement in much of the published literature of a concept introduced to me last year, treatment implementation.
       The concept of treatment implementation involves measuring the extent to which the desired treatment has been delivered accurately and consistently (delivery); the extent to which patients understand the treatment (receipt) and the extent to which clients are able to utilize the skills taught in the treatment in their lives (enactment). In order for a treatment to be considered effective, it must be used by the client. And, it is this enactment we as researchers and clinicians rely upon to determine the efficacy of the treatment. Yet, if we do not know the extent to which the treatment was delivered accurately, or if the client understood the treatment, any measurements of enactment are virtually meaningless. An understanding of these three components of any treatment is crucial to determine its efficacy. That way, we can determine if it is the treatment, or simply the passage of time and the relationship between the therapist and client, that made a difference in the client's life. Clinicians need to understand how treatment implementation is - or is not - assessed in studies in order to make educated decisions regarding the effectiveness of the treatment.
       As the field of psychology moves toward an empirically based practice, I encourage all of us to consider treatment implementation as we draw conclusions from treatment studies. By being mindful of the strengths of our research and of the potential weaknesses, we can continue to provide the highest quality of care for each of our unique clients' needs.
       Please do not hesitate to contact myself (phill094@bama.ua.edu) with ideas, questions or just to introduce yourself!

Profile on: Donna Rasin-Waters, Ph.D.
Gerontology Resources, Inc. Brooklyn, New York

       Donna Rasin-Waters, Ph.D., began working with older adults in the late 1980's when there was a trend for mental health clinics in the New York City metropolitan area to hire and place graduate students in nursing homes with a fee for service arrangement. What began as a group of six clinicians assigned to various nursing homes soon burgeoned into fifty therapists providing services to the elderly before the Medicaid funds for such work were cut from the budget.
       The extensive audit process that resulted in loss of funds for mental health treatment of older adults impressed Dr. Rasin-Waters with concern both about the quality of psychotherapy being conducted as well as the documentation of those services. She remained concerned about the same issues once Medicare privileges were granted to psychologists in 1991 and there was a burgeoning of the same type of agency led influx of licensed psychologists into nursing homes in fee for service arrangements. This prompted Dr. Rasin-Waters to begin offering training for psychologists providing psychotherapy services in long term care and by 1996 she developed Gerontology Resources, Inc., an APA approved sponsor for continuing education for psychologists. In addition to promoting extensive training and consultation for clinicians who provide services to older adults, she encourages psychologists who may be working in isolation in nursing homes, private practice and other settings to establish peer consultation networks. Psychologists who establish such networks can assist each other with case review and tracking of local CMS policy.
        Dr. Rasin-Waters received her doctorate degree in clinical psychology from Long Island University, Brooklyn, New York in 1991. She has provided psychological services to older adults and their families in private practice, nursing homes, adult day programs and inpatient geropsychology. She has been a consultant for the dementia training project in nursing homes led by the New York City Chapter of the Alzheimer's Association. She has also served as president of the Adult Development and Aging Division of the New York State Psychological Association, and Independent Practitioners in Geropsychology, a metropolitan New York City based peer group. Most recently she was appointed the Public Policy Chair for Division 12, Section II and looks forward to continuing the ongoing work of the committee and developing projects to assist psychologists in voluntary compliance with CMS.
       If you would like to contact Dr. Rasin-Waters please do. Her practice is located in Brooklyn, NY. email: gerontologyres@rocketmail.com

Section II at GSA 2003
Note the following information was provided by participants. Any corrections/additions can be made ia Section II listserve at:
WVUGER-L@LISTSERV.WVU.EDU

Saturday, 11/22/03

Symposia:

10:30 AM (rm., NA):
        1. Resources for Enhancing Alzheimer's Caregiver Health (REACH): Overview and Site Specific
            Outcomes. Discussant: L. D. Burgio,

1:30 PM- 3:00 PM (rm., NA):
        1. Evidence Based Behavioral Training for Staff in Long-Term Care. L. D. Burgio, et al.
            Discussant: Linda Teri

Poster Sessions:Room: 5, Exhibit Hall A (CC):

1:45 PM-3:15 PM:
        1. Stress and Coping Among African-American and White Older Adult Gay Men. Steven David,             Bob G. Knight
       2. Outpatient Geriatric Mental Health Training: Preparing to Meet the Demand. S. M. Ogland-
            Hand & A. Steffen,
       3. Cognitive impairment, health, and anxiety in a nursing home sample. K. B. Tennyson & S.
            Meeks
       4. Factors that influence coping with severe mental illness in late life. E. G. Burton, S. Meeks, & B.
            Farese

4:00 PM
       1. A staff-assisted behavioral intervention for depression in nursing home residents: Preliminary
        pilot outcomes. S. Meeks, L. Teri, K. Van Haitsma, & S. Looney

Sunday, Nov. 23rd

Symposia:

8:30 AM (rm., NA):
        1. Caregiver Skill Building Interventions: Findings and New Directions. C. J. Farran, D. W. Gilley,             C. M. Connell, & C. Castro. Discussant: L. D. Burgio.

1:30 PM (rm., NA):
        1. Assessment and Interventions in Diverse Settings. M. Crowther, R. Allen, A. Coates, M.             Morthland, F. Scogin, A. Kaufman, L. Burgio, L. Beutler, L. Phillips, D. Whitehead, L. Kelly, R.             Rodriguez, P. Baker, R. Allman, M. Snarski, & L. Swanson.

1:45 PM (rm., NA):
        1. Mental Health Practice and Aging: Multidisciplinary Perspectives on the Treatment of Late Life             Depression. M. Karel, J. Sandberg, M. Kaplan, M. Kaplan, M. Lewis, & Mary Miller Lewis.             Participants: C. Reynolds, Treatment of depression in old age: The importance of combined             treatments; R. Haverkamp, IMPACT treatment model: a collaborative stepped care program             for depressed older adults in primary care; R. Miller: Towards an interactional description of             depression in later life: Implications for clinical practice. Discussants: G. Hinrichsen, R.             Toseland, J. Unutzer

3:30 PM-5:00 PM, rm. 18, Upper Level 1A (CC):
        1. Ethical Issues in Geriatric Mental Health. Participants: F.J. Kier & V. Molinari: "Do it Yourself"             Dementia Testing: Issues Regarding an Alzheimer's Home Screening Test. J. Moye, M. Karel,             A. Azar, R. Gurrera: Issues in Competency Assessment: Benefits and Limitations of
            Standardized Tool. P.L. Farrell & B. Lauber: Home-Based Psychological Services: Ethical &             Treatment Challenges. M. Duffy & B. Karlin: Public Policy, Ethics and Informed consent in             Nursing Homes. Discussant: M. Kapp

Poster Sessions: Room: 5, Exhibit Hall A (CC):
8:00 AM - 9:30 AM:
        1. Living History Spiritually… Or Not? A Comparison of Conventional and Spiritually-Integrated             Reminiscence Groups for Elders. Erin E. Emery

Monday, 11/24/03

Symposia:

10:30 AM (rms., NA):
       1. Different Perspectives on Quality of Care. M. R. Crowther, R. Allen, J. Davis, M. Hardin, J.
           Lorenzen, L. Burgio, S. Fisher, T. Pierce, J. Shuster, G. MacNeil, R. Rodriguez, & L. Swanson.
           Discussant: F. Scogin.
       2. Characterizing Rater Agreement in Nursing Home Research. S. E. Fisher, M. M. Hardin, L. D.
           Burgio.

10:45 AM-12:15 PM; Upper Level 4 (CC)
       1. Will HIPAA change mental health care for older adults? : Effects on three clinical settings.            Participants: Donna Rasin-Waters, Paula Hartman-Stein, and Steve Sohnle. Discussant:            Margie Norris.

Poster Sessions - Room: 5, Exhibit Hall A (CC):

8:00 AM- 9:30 AM.
       1. Neuropsychological Functioning and Depressive Symptoms in Older Veterans with Cognitive            Impairment. Carey A. Pawlowski, Edward M. Kendjelic, Frederick J. Kier, & Michelle M. Lee

Tuesday, 11/25/03

Symposia:

10:45 AM (rm. 8, Marriott Hall 3 (M)):
        1. Assessing Nursing Home Residents' Pain: Conceptual and Methodological Issues. V.F.             Engle. Participants: A. L. Snow, D. Novy, K. O'Malley, M. Cody, E. Bruera, C. Beck, C. Ashton,             & M. Kunik, A Conceptual Model Of Pain Assessment For Noncommunicative Persons With             Dementia. A.L. Horgas, S.M. McLennon, A.L. Floetke, Methodological Issues In Assessing             Pain In Persons With Dementia. K.A. Talerico, L.L. Miller, M. Lasarev, P.D. Sloane, C.M.             Mitchell, Personal Care As A Stimulus For Observed Pain Expression And Assaultive             Behavior. E. Fox-Hill, V.F. Engle, M. Graney, L. McKeon, Communication Strategies For Multi-
            Modal Pain Assessment To Improve Accuracy Of Nursing Home Residents' Responses.               Discussants: J. A. Teresi & K. Feldt.

Poster Sessions: Room: 5, Exhibit Hall A (CC):

8:00 AM- 9:30 AM.
        1. The Ability to Decide Advantageously Declines Prematurely in Some Normal Older Persons.              Natalie Denburg, Antoine Bechara, & Daniel Tranel.

Member news....
        Coon, David W., Gallagher-Thompson, D., & Thompson, Larry W. (Eds.) (2003), Innovative Interventions to Reduce Dementia Caregiver Distress: A Clinical Guide, Springer Publishing Company, NY.
        "This volume provides an overview of emerging themes in dementia research and presents a broad array of practical strategies for reducing caregiver distress, including interventions for specific populations such as ethnic minority caregivers, male caregivers, and caregivers with diverse sexual orientations. Innovative approaches include the value of partnering with primary care physicians to improve quality of life for both patient and caregiver and the use of technological advances to help distressed caregivers. A timely, cutting edge book written for clinicians of varying backgrounds who provide direct services to families of those with dementia."

        Laidlaw, Ken, Thompson, Larry W., Dick-Siskin, Leah, & Gallagher-Thompson, Delores. (2003). Cognitive Behavior Therapy with Older People. John Wiley & Sons, England.
        Forward by Aaron T. Beck, M.D., " . . . At its core the book never wavers from its strong empirical basis and each chapter provides a review of evidence for the application of CT before giving clinical guidance on treatment issues. The book provides an in-depth and cutting edge guide to the use of CT with older people and, in reality, there is no other text with this depth of coverage on the market.
        "This text reflects the collective experience of four geriatric mental health practitioners/researchers working in a variety of settings for over a decade developing and evaluating innovative clinical solutions for improving the mental health care needs of older people. The authors are known for their commitment to the betterment of treatments for older people and this remains the main aim of their book."