In the Wake of a Veto: What Do Oregon Psychologists Think and Know about Prescription Privileges for Psychologists?

Clinical psychology continues to grapple with a contentious debate surrounding prescriptive authority. With over half of all states having considered legislating prescriptive authority, an immense amount of time and money has been invested. This study aims to assess knowledge and attitudes of licensed psychologists in Oregon following a veto that prevented it from becoming the third state with prescription privileges for psychologists. From a list of 1,318 licensed Oregon clinical psychologists, 60% were randomly selected to participate. Of the 130 participants invited thus far, 83 have completed the survey, yielding a respectable response rate (64%). Perceived familiarity with current training models revealed lacking awareness with 75.2% and 72% expressing they were not familiar with the DOD and APA models, respectively. Only 5% knew which three states/territories currently have prescriptive authority and 77% were unfamiliar with any of the three prerequisites for postdoctoral training in psychopharmacology. Arguments in favor of prescription privileges garnering the most support related to perceptions of improved access and treatment enhancement. In contrast, the strongest arguments against prescription privileges involved professional issues (e.g., altered identity). Reflecting division, 43.9% were in favor, 20.7% were undecided, and 36% were in opposition to broadening privileges for psychologists. However, only 15.9% expressed interest in completing training and only 7.2% plan to pursue training and become a prescriber. Overall, these findings suggest legislative efforts should be mindful of the controversy within the field and the low numbers of professionals interested in pursuing prescription privileges, which undercut arguments for improved access and care

Pocket ACE: Neglect of Child Sexual Abuse Survivors in the ACEs Study Questionnaire

In 1998, a seminal study on adverse childhood experiences (ACEs) and subsequent health risks catapulted ACEs and the study questionnaire into the zeitgeist. However, its childhood sexual abuse (CSA) item is problematic as it requires the perpetrator have been 5-years or older than the victim. To assess whether some survivors’ CSA is not identified by the current item, whether their exclusion prevents access to services requiring a four-threshold ACE score, and how their health outcomes compared to other CSA groups and controls, an international sample of 974 women completed an online survey assessing their current health and CSA history using the original item and an experimental item without the 5-year modifier. Results indicated many CSA survivors are not identified by a 5-year modifier, exclusion has service implications for some, and on most variables, they had increased adverse health outcomes compared to controls. Means of assessing CSA must be thoughtfully revised

Internal and External Factors Associated with Illicit Prescription Drug Use in College Students

With data suggesting emerging adulthood is a time of increased risk for illicit prescription drug use, it is essential that factors contributing to this be understood to guide prevention efforts. Internal factors (stress, GPA, gender) and external factors (type of institution, living situation) were assessed in tandem with perceptions of harm and illicit prescription drug use. In accordance with nationwide research (SAMSHA, 2006), 14% of our sample of Oregon college students reported illicitly using prescription drugs. While rates of use did not vary by gender, females held higher perceptions of harm. Perceived harm was high for our sample and inversely correlated with use. Those living on campus reported higher perceptions of harm and less use than those living off campus. Those attending private academic institutions reported higher perceptions of harm and less use than those attending public institutions. Previous studies suggest a heightened sense of community within schools, comparatively present within private institutions, can reduce drug use (Battistich, & Hom, 1997). Stress was positively correlated with use and GPA was negatively correlated with use. While numerous studies have examined various correlates of prescription drug use, few have sampled beyond a single institution, most within public universities. Thus, the inclusion of private institutions offers unique and a more holistic insight. As drug use continues to increase in college populations even with prevention programs in place, it is imperative to translate these findings into prevention targeting both genders, at times of stress, particularly those living off campus, at public universities, with lower GPAs

Data-Driven Change in Oregon Psychologists’ Knowledge and Attitudes about Prescriptive Authority

With over half of all states having considered legislating prescriptive authority, an immense amount of time and money has been invested. The literature is limited in terms of understanding if opinions toward prescriptive authority are grounded in knowledge and what implications that has for altering these opinions. Following a veto of a prescriptive authority bill in Oregon, 160 licensed Oregon clinical psychologists were surveyed regarding their attitudes and knowledge. In terms of knowledge, only 5.6% knew which three states/territories currently have prescriptive authority and 70.4% were unfamiliar with any of the prerequisites for postdoctoral training in psychopharmacology. Reflecting division, 42.8% were in favor, 20.1% were undecided, and 37.1% were in opposition to broadening privileges for psychologists. Further, only 15.1% expressed interest in pursuing training or 6.4% in becoming a prescriber. Data on access, training, and legislative costs were presented to participants in the education condition. These participants showed significant gains in their knowledge across all domains and their opinions shifted only in these specific areas leaving their general stance on the issue unchanged. In contrast to ardent supporters who argue that their “data should provide reassurance to psychologists spearheading legislative initiatives” because of high approval ratings (Sammons et al., 2000, p. 608), our data suggest disagreement amongst a group of professionals who are not particularly well-informed, nor interested in becoming prescribers. Future work should investigate whether expanding the data relevant to other facets of the argument contributes to further targeted change or an overall change in opinion toward prescriptive authority

Explaining the Variation in the E-Government Characteristics of Municipal Websites: An Analysis of E-Content, E-Participation, and Social Media Features in Municipal Websites in Canada

This paper examines the variation of specific e-Government features in Canadian municipalities and it assesses the quality of municipal websites by evaluating their ability to meet criteria in the three areas of e-Content, e-Participation, and social media capacity. An e-Government Index was developed to evaluate website quality with respect to the three areas and a study of medium-sized Canadian municipalities – excluding those in Quebec – was conducted. The findings reveal that as a whole, medium-sized municipalities in Canada are more successful at developing the e-Content features of their websites compared to the e-Participation features, demonstrating that they are better at delivering information than they are at engaging citizens in online participation, and there is little use of social media in most municipalities

An examination of ideology among selected K12 Christian school superintendents

This research project focused on explaining the decision-making process of K12 Christian school superintendents who were members of the Association of Christian Schools International (ACSI) organization. In spite of similar religious and philosophical beliefs, it was observed that ACSI K12 Christian school superintendents differed significantly in organizational decision-making.This dissertation investigated the construct of ideology as a possible explanation of this phenomenon. This project attempted to explain the ideology of selected Christian school superintendents, uncover the formation of ideology throughout life, and demonstrate usage ideology in organizational decision-making. This study used a qualitative research methodology with narrative analysis in the phenomenological research tradition. Nine K12 Christian school superintendents throughout Michigan, Indiana, and Ohio participated in the study. The research methodology included development of a grand narrative for each participant, thematic development of ideology for each participant, and an axial thematic analysis across all nine superintendents. Transcripts, grand narratives, research journals, and artifacts were used as research records to help discover participant ideology. Findings of the project revealed that ideology consists of four elements. Values, situations-of-conflict, commitments, and influences were important in forming participants’ ideologies. Additionally, these four elements were found to exist in a relationship to each other. The results of those relationships revealed that ideology is a blend of values to satisfy superintendent commitments; that value selection is dependent on the situation-of-dilemma; and that influences in life affect commitments and values. From those relationships a framework evolved. The framework was shown to supplement Thompson’s (2008) organizational model and expanded his propositional hypotheses about organizational behavior

A Pandemic’s Potential to Haunt: A Longitudinal Look at the Professional Wellbeing of TN’s Infant and Early Childhood Mental Health (IECMH) Workforce

Infant and Early Childhood Mental Health (IECMH) providers engage in uniquely relational work with high-risk families that expose them to the full advantages (i.e., compassion satisfaction [CS]) and disadvantages (e.g., burn-out [BO]) of a helper role. Though the pandemic seemed poised to escalate disadvantage, most early pandemic studies found high CS alongside elevated BO. Unfortunately, as COVID-19 has continued, CS has declined while BO has increased. Given the delayed COVID-19 impact on children, these changes may be particularly acute for IECMH providers. Using a longitudinal cohort of 27 IECMH providers, this study aimed to describe and quantify changes in professional wellbeing and contributing factors over a 12-month period (T1 – T12) from early to mid-pandemic. Little changed from T1 to T12 for IECMH provider CS (M = 41.33 vs. M = 41.08) or BO (M = 22.22 vs. M = 22.65) scores. Variables known to contribute to CS similarly held when T1 was compared to T12, but they fluctuated considerably and non-linearly between these time points. Variable relationships with CS also changed over time necessitating an adjusted hierarchal regression model. This model accounted for 20% of variance in T12 CS. Pandemic experiences like loss are reported; needs/supports are summarized using content analysis. Results underscore the importance of cohort, multi-time point design and the need for non-linear analysis to contextualize the interplay of shared and individual experiences within COVID-19. Implications for maintaining IECMH professional wellbeing moving forward and improving the health of other fields are discussed

Tax Policy Issues Relevant to Captive Insurance Companies in Alberta

Alberta recently enacted legislation that will permit the creation of captive insurance companies. This legislation will not come into force until Proclamation, which is unlikely to occur before detailed regulations are promulgated to address capital requirements, financial reporting standards, the lines of insurance business that captives may undertake, or the persons who may be insured. These critical regulatory items are the subject of a separate research paper on the captive insurance market published by the School of Public Policy