Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families

 
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Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
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Psychologist
Publication of the Florida Psychological Association			   Summer 2018

        The Psychological Impact on Immigration
        Policies on Migrant Children and Families
                                        See page 10

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Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
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Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
TABLE
OF CONTENTS                                                      PRESIDENT’s message

Feature Articles                                                 By Tim Ketterson, PhD

6    EXECUTIVE DIRECTOR’S MESSAGE
     Carolyn Stimel, PhD, ABPP

8    PARKLAND TASK FORCE RELEASES 100
     RECOMMENDATIONS
     The Associated Press

                                             G
10 THE PSYCHOLOGICAL IMPACT OF                         reetings FPA Members. Summer is upon us in Florida with
   IMMIGRATION POLICIES ON MIGRANT                     its crushing heat and humidity that are often tempered by
   CHILDREN AND FAMILIES
   Kristin Hoffman, PhD                                afternoon storms offering torrents of rain, grumbles of thunder
                                             and jagged bolts of lightning, and occasional tropical systems that send
14 VICARIOUS TRAUMA                          we mortals scurrying for safety. In organizing my thoughts for this
   Juliana Gerena, PsyD; Raven Oshiro, MS;
   Adriana Ramirez, MS; Taylor Loftus        issue of the Florida Psychologist, I have been struck by the menacing
                                             specters of current social, political, and economic issues clouding our
18 USING MINDFULNESS TO TREAT SMOKING        day-to-day lives, perhaps, in a more profoundly unsettling manner than
   Michelle Blose, MS
                                             our state’s changeable weather.
20 ACCEPTANCE AND COMMITMENT THERAPY              In addition to weather-related natural disasters, communities
   Leah Power, PhD                           around our state have been struck with heartrending loss-of-life from
21 A CAUTIONARY TALE FROM THE BOARD OF       mass shootings (Pulse Nightclub on 6/12/2016, Parkland High School
   PSYCHOLOGY MEETING                        on 2/14/2018), and a structural disaster (the FIU bridge collapse on
   Carolyn Stimel, PhD, ABPP                 3/15/2018). Earlier this month, Florida received a deluge of media
22 POLITICAL COMMITTEE FUNDRAISER            attention as part of the unfolding narrative concerning the current
   Regina Mendoza, PsyD                      administration’s policy of separating immigrant children from their
                                             families when suspected of entering the United States illegally.
23 FROM AROUND THE STATE
                                             Diligent and timely advocacy efforts by the American Psychological
24 SOMATIZATION AND SUSTANCE USE             Association (APA) and SPTAs from southern border states including
   DISORDER                                  Arizona, California, New Mexico, and Texas were instrumental
   Michelle Blose, MS
                                             in securing President Trump’s recent Executive Order ending the
25 HELP! I GOT A SUBPOENA! WHAT DOES A       policy of separation of immigrant children from their parents. Citing
   SUBPOENA DUCES TECUM MEAN?                decades of psychological research showing that children separated
   Carolyn Stimel, PhD, ABPP
                                             from their parents can suffer severe, clinically-relevant psychological
27 MEMBERSHIP UPDATE                         distress, APA challenged the administration to reunite the children
   Terilee Wunderman, PhD                    with their families in a timely manner and offered to assist in securing
                                             psychological services for those affected.
28 LAPPB UPDATE
   Andy Hicks, PhD                                In South Florida, the Department of Health and Human
                                             Services (DHHS) operates The Homestead Temporary Shelter for
30 DIVERSITY COMMITTEE UPDATE                Unaccompanied Children, an Office of Refugee Resettlement (ORR)
   Gary Howell, PsyD
                                             emergency shelter (see https://www.acf.hhs.gov/orr). Services at this
38 TREASURER’S REPORT                        facility are delivered under contract by Comprehensive Health Services,
   Thomas Bonner, PhD, ABPP                  Inc. of Cape Canaveral FL (DBA Chsi) and can house upwards of
40 FORENSIC ISSUES                           1,300 immigrant children. FPA supports APA’s efforts in advocating
   Lori Butts, JD, PhD                       for the psychological welfare of the innocent and disenfranchised
                                             and stands ready to assist in getting these children the psychological
41 MEDICAL PSYCHOLOGY DIVISION
   Christopher Rossilli, PsyD, MSCP, MS      services they need during the time they are in U.S. custody and upon
                                             their release.
42 NEUROPSYCHOLOGY DIVISION                       On another solemn note, the recent deaths of two American
   Jennifer Katzenstein, PhD, ABPP-CN        celebrities (fashion designer, Kate Spade and chef, writer, and
                                             television show host, Anthony Bourdain) by suicide reflect a growing
In Every Issue                               national crisis according to a recent report released by the Centers for
26   CLASSIFIEDS
29   NEW MEMBERS                             Disease Control (CDC). The report examined data between 1999 and
44   MEMBER SPOTLIGHT                        2016 from the National Violent Death Reporting System, which collects
45   SUSTAINING MEMBERS                                                                            continued on page 5
46   POLITICAL COMMITTEE CONTRIBUTORS
48   CPE QUIZ - SUMMER 2018                                                                          Florida Psychologist • 3
Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
Florida

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4 • Summer 2018
Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
2018 FPA BOARD OF DIRECTORS
Message from the President
cont’d from page 3                                                          Executive Committee:
                                                                            President .............................................................Tim Ketterson, PhD
                                                                            President Elect ....................................Jessica Vassallo, PhD, ABPP-CN
                                                                            Immediate Past President ...........................Nekeshia Hammond, PsyD
data from death certificates, coroner and medical examiner reports, and
                                                                            Secretary ..............................................................Gary Howell, PsyD
law enforcement in 27 states. During this period, suicides increased by
                                                                            Treasurer ............................................................... Tom Bonner, PhD
25 percent across the United States. An alarming 45,000 Americans
                                                                            LAPPB Chair ......................................................... Andrew Hicks, PhD
(age 10 or older) died by suicide in 2016 alone. APA has suggested          APA Council Representative ........................ David B. Kazar, PhD, ABPP
suicide needs to be a public health priority addressed via a multifaceted   FPAGS......................................................................Marilyn Paradoa
public health approach in which we increase access to mental health
screenings and ensure that insurance covers both prevention services        Chapter Representatives:
and treatment. Further, the science and practice of psychology play an      Bay ................................................................. Kimberly Kinsler, PhD
essential role in both understanding and addressing the biopsychosocial                                                                              Melina Scally, PsyD
underpinnings of suicide. This crisis affects people both with and          Brevard/Indian River ..............................................Helen Barnet, PhD
without diagnosed mental health conditions. Suicide is often an act         Broward ............................................................ Craig Fabrikant, PhD
of desperation, brought on by an inability to cope with life’s stressors                                                                            Laura A. Cohen, PhD
some of which have been termed “Deaths of Despair” in a 2015 report         Calusa .................................................................... Kelly Russo, PhD
by economists Anne Case and Angus Deaton in the Proceedings of              Capital .................................................................. Craig Asselin, PhD
the National Academy of Sciences. If you or someone you know is             Central ...........................................................David J. Romano, PhD
struggling, call the National Suicide Prevention Lifeline at (800) 273-     Miami-Dade-Monroe ....................................Terilee Wunderman, PhD
8255 or SMS Text the word “TALK” to 741741 for assistance.                                                                                           Franklin Foote, PhD
    As the dog days of Summer give way to the cooler evenings               Lower West Coast ..................................................Diane McKay, PsyD
of Fall, several noteworthy events and initiatives will begin to take       North Central ............................................................Harry Krop, PhD
shape. In late September 2018, FPA will be hosting a Leadership             Northeast .......................................................... Darah Granger, PsyD
Training Retreat in Orlando. We also are entering an active period of       Palm ........................................................... Cynthia Silverman, PsyD
planning for the Statewide FPA Conference in 2019, and the Executive                                                                                Russell Bourne, PhD
Committee will begin to report on lessons learned from the Regional         Pinellas ......................................................... Harold Schinitsky, PhD
Conferences pilot.                                                          West .................................................................. Ron Yarbrough, PhD
    In closing, I thank you for your esteemed collegiality, your
continued support of FPA and daily contributions toward its Mission.        COMMITTEE CHAIRS & APA LIAISONS
                                                                            Disaster Response Network ...............................David J. Romano, PhD
    Sincerely,                                                              Diversity ...............................................................Gary Howell, PsyD
    Tim                                                                     Continuing Education ............................................David Chesire, PhD
                                                                            Early Career Psychologist ..........................................Leah Power, PhD
   “Hope springs eternal in the human breast…” (Alexander Pope)             Elections & Awards ....................................Nekeshia Hammond, PsyD
                                                                            Ethics Advisory .................................................. Craig Fabrikant, PhD
                                                                            Federal Advocacy ............................................. Kristi Van Sickle, PsyD
                                                                                                                                            Stephen Bloomfield, EdD
                                                                            Finance ................................................................. Tom Bonner, PhD
                                                                            General PAC.................................................... Regina Mendoza, PsyD
                                                                            Health Care Policy ................................................Michael Smith, PhD
                             THE FLORIDA SOCIETY                            Legislative Affairs and Policy................................... Andrew Hicks, PhD
                                                                            Membership .................................................Terilee Wunderman, PhD
                             OF CLINICAL HYPNOSIS                           Prescriptive Authority.................................. Anthony S. Ragusea, PsyD
                                                                            Public Education Coordinator ...............................Laura A. Cohen, PhD
                        is offering a 20 CEU hours
   Basic Workshop, Fundamentals of Hypnosis With                            DIVISION PRESIDENTS
   Applications, in Orlando, July 20-22, presented by                       Child, Adolescent and Family .............................. Craig Fabrikant, PhD
   FSCH Master Teachers Louis Damis, PhD, ABPP,                             Forensic Psychology ..........................................Karen Feuerman, PhD
   Stephen Warner, PhD, and Larry Goldman, MD.                              Medical Psychology .................................................Chris Rossilli, PhD
   See: www.fsch.org/workshops/basic-workshop, or                           Neuropsychology ................................................. Lamar Ingulli, PsyD
                                                                            Women’s Issues .................................................Christina Brown, PhD
   call (305) 598-9992.

                                                                                                                                Florida Psychologist • 5
Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
From the Executive Director
                             By Carolyn Stimel, PhD, ABPP
                             Executive Director/Director of Professional Affairs

   R
            ecently, several volunteer            to review all the pending legisla-
            groups within FPA have been           tive and administrative issues         Dr. Karim Yamout has repre-
            working on clarifying the role        that could affect psychological         sented us for several years on the
   of professional associations with the          practice. Our main lobbyist is          state task force that is working on
   goal of impressing upon professionals          Darricke McGee of the Johnson           elder caring issues.
   why membership matters. More                   and Blanton firm. The three of us
   than 90% of FPA’s operating budget             review the more than 2000 bills        Several psychologists have met
   comes from member fees and a good              that are filed every year for po-       with their local legislators seek-
   chunk of our activities are done by            tential implications for psycholo-      ing support for a prescribing psy-
   volunteer members who are invested             gists. Darricke can meet with           chologist bill we plan to file next
   in professional development and                legislators and their staff when        session.
   advocacy. Central Office staff has             bills are potentially dangerous for
   one full time employee (Nickcole               us and assist us in promoting the      I meet and communicate with
   Caldwell) who handles the phones,              legislation that is helpful.            other mental health association
   works on referral requests and does                                                    directors on issues such as Tri-
   the processing of all the continuing        In January, more than twenty              care, Blue Cross rates, and the
   education credits. Kim Campbell is           members from around the state             cuts to forensic evaluator rates.
   a half-time employee who processes           traveled to Tallahassee for two           Just today I attended a meet-
   memberships, handles the web site,           days of legislative training and          ing with APA staff and the other
   and does our mailings along with our         meetings with their local legisla-        states’ Directors of Professional
   publications. Danielle Humphreys             tors at the capitol. FPA provided         Affairs to obtain updates on the
   returned to us at ten hours a week and       travel expenses, meals and hotel          issues that every state is dealing
   assists the others with their tasks as       rooms.                                    with such as further restricting
   well as special projects. I am a ¾ time                                                psychologist licenses and trying
   employee, keeping the ship afloat.          In March five FPA members went            to get PsyPact enacted. My par-
   One of the non-tangible benefits that        to the APA Practice Leadership            ticipation in listservs for Execu-
   comes from a professional association        Conference to attend sessions             tive Directors and the Directors
   is that of advocacy for the profession.      on federal issues and meet with           of Professional Affairs allows me
   I know that it sometimes seems we            our federal legislators at the U.S.       to monitor nationwide events for
   are in a losing battle in terms of           Capitol. This annual trip is done         impending threats based on what
   protecting the value of our profession.      with cost sharing by APA and              the other states are handling.
   So, what does the advocacy piece             FPA. It allowed us the opportuni-
   involve? Below, I have outlined some         ty to express our concerns about         Last year several of us testified
   of the activities, particularly over the     Tricare to APA staff working on           at the legislatively mandated
   past year, that staff and volunteers         the federal level.                        task force meetings examining
   have been doing, in many cases with                                                    telehealth issues. This group
   financial support from FPA.                 Dr. Lori Butts represented FPA            generated a report with multiple
                                                at meetings of the legislatively          recommendations, including the
       FPA pays a lobbyist to monitor          mandated Forensic Interview               need for third party payers to ad-
       and assist with legislative issues.      Task Force which is finalizing            equately reimburse such services.
       The lobbyist, Legislative Chair          their report on recommended best          Unfortunately, none of these were
       Dr. Andy Hicks and myself have           practices for forensic interview-         considered in the 2018 legislative
       meetings every few weeks (and            ing of child victims of abuse and         session.
       weekly during the two-month              violence. FPA takes care of travel
       legislative session) to review           expenses whenever we are on a            The North Central chapter in
       pending issues. This allows us           task force.                               Gainesville had a successful town

6 • Summer 2018
Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
2019 FPA Conference survey

                  Q1 I would _____ attend a statewide FPA Conference.
                                                       Answered: 225     Skipped: 0

                           Not

                   Probably Not

                      Probably

                      Definitely

                                   0%   10%   20%     30%    40%       50%    60%      70%     80%     90% 100%

 ANSWER CHOICES                                                                       RESPONSES

 Not                                                                                  2.22%                                          5

 Probably Not                                                                         17.78%                                        40

 Probably                                                                             63.11%                                       142

 Definitely                                                                           17.78%                                        40

 Total Respondents: 225

    hall meeting to talk about current              sent FPA when they occur in their               I hope that this gives you and idea
    concerns. The Bay chapter in                    area.                                      of the range of advocacy activities
    Tampa held a well-attended meet                                                            that FPA works on as we monitor and
    and greet for mental health pro-           Our Federal Advocacy Coordina-                 influence decision making in a variety
    fessionals as well as other service         tors (Drs. Stephen Bloomfield                  of areas around the state. If you ever
    providers in their area. Events             and Kristi VanSickle) work with                have any questions, reach me at
    like these introduce psychologists          APA to advocate and disseminate                carolyn@flapsych.com.
    to other professionals and put              the Action Alerts on the national
    our profession forward. FPA sup-            level.                                         Survey Results
    ports all the chapter activities and                                                            I was quite pleased that 225 FPA
    needed funds for those.                    FPA works closely with the                     members responded to our questions
                                                governing board of the Political               for the 2019 convention we are
 Five days a week I review admin-              Committee (PAC) to make deci-                  planning (see results above). We are
  istrative rule changes made by                sions about the use of campaign                shooting for some time in September.
  multiple state agencies in order              contributions. I function as the               Take a look at the results. They are
  to monitor potential changes that             treasurer for those funds and                  fairly clear and self-explanatory.
  might affect psychological prac-              several FPA leaders serve on that              Thanks to all of you; it really helps in
                                                             1/7
  tice. I also review every Board               board.                                         the planning efforts!
  of Psychology meeting either in              I consult with members all the
  person or afterwards via audio in             time on how to report other pro-
  order to monitor their actions. In            fessionals who misrepresent their
  addition, a number of our mem-                credentials or operate outside
  bers attend the meetings to repre-            their scope of practice.

                                                                                                                      Florida Psychologist • 7
Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
Parkland Task Force Releases
                                  100 Recommendations
                                                   By The Associated Press

   A
            task force                                                                            keeping classroom
            has released                                                                          doors locked at all times
            a report with                                                                         and installing cameras
   100 recommendations                                                                            to monitor every inch of
   for keeping kids safe in                                                                       school grounds.
   the wake of the Florida                                                                            The task force says
   school shooting that                                                                           schools should evalu-
   killed 17.                                                                                     ate whether student
        The Broward Coun-                                                                         discipline measures are
   ty task force released                                                                         being enforced consis-
   the report Monday but                                                                          tently and re-examine a
   noted it will be difficult                                                                     diversion program de-
   to fund the measures,                                                                          signed to keep students
   which include hiring                                                                           out of the school-to-
   additional school coun-                                                                        prison pipeline. Nikolas
   selors, therapists and                                                                         Cruz, the suspect in
   school police officers                       The task force also recommends                    the Parkland shooting,
   and hardening schools with metal         random searches at schools, raising      had been referred to the program in
   detectors and window coverings.          the heights of fences around schools,    middle school but did not complete it.

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8 • Summer 2018
Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
Florida Psychologist • 9
Psychologist - The Psychological Impact on Immigration Policies on Migrant Children and Families
FEATURE

                   The Psychological Impact of Immigration
                   Policies on Migrant Children and Families
                                                  By Kristin Hoffman, PhD
                              Director, Trauma Psychology, Johns Hopkins All Children’s Hospital

   B
            y now, most,                                                                                 posttraumatic stress
            if not all of                                                                                (Trickey et al., 2012).
            us, have heard                                                                               Similarly important
   about the Trump Ad-                                                                                   are the reactions of
   ministration’s “Zero-                                                                                 the child’s caregivers
   Tolerance” policy that                                                                                during and following a
   involved separating im-                                                                               trauma. A stable, sup-
   migrant children from                                                                                 portive caregiver who
   their parents detained at                                                                             is available to help a
   the U.S.-Mexico border                                                                                child feel safe and cope
   and then subsequent                                                                                   in effective ways is one
   executive order end-                                                                                  of the most important
   ing this practice. While                                                                              protective factors and
   this policy reversal                                                                                  predictors of positive
   may protect future im-                                                                                adjustment following
   migrants from family                                                                                  a traumatic experience
   separations, many ques-                                                                               (Bonanno & Diminich,
   tions remain about the                                                                                2013).
   order and upcoming immigration legislation. For instance,           It is essential to consider the past and current experi-
   what is the plan for reuniting the 2,000 plus families who     ences of U.S. immigrants and refugees in light of this
   have been separated? Now that families will be detained        research. Data from the Migration Policy Institute (Rosen-
   together, where will they be housed and what type of treat-    blum & Ball, 2016) indicate a dramatic increase in arrivals
   ment will they receive? What are the potential conse-          of undocumented children from Guatemala, Honduras, and
   quences of family separation and detention on the mental       El Salvador beginning in 2014, which corresponds with
   health and well-being of migrant families? Over the past       the escalation of violence and poverty in these countries.
   few years, immigration has become a focus of American          In a 2013 study conducted by the United Nations High
   politics, with many divided over the impact of immigra-        Commissioner for Refugees (U.N. Refugee Agency, 2014),
   tion on our country and the best way to address it through     58% of the approximately 400 unaccompanied minors in
   legislation. During times of divisive political policies and   the U.S. that were surveyed reported they had suffered
   rhetoric, it is important for us as psychologists to look      or been threatened with serious harm that was sufficient
   beyond our political views to what science is saying about     enough to merit protection under international law. The
   the impact of policy decisions on children and families.       trauma and violence that causes many families to flee
                                                                  their countries may follow them during their journey to
   Trauma and Stress among Immigrant Families                     the U.S., where conditions are often dangerous and over-
       Decades of research have taught us that separating         crowded. Due to their histories of repeated and chronic
   children from their caregivers is stressful and potentially    trauma, children from immigrant families seeking asy-
   traumatic and that how children react to stress is depen-      lum in our country are a vulnerable population. Abruptly
   dent upon a number of factors. Delayed development,            separating children from their parents at a time when they
   lower socioeconomic status, prior experiences of adversity     need their parents’ love and protection the most puts them
   and trauma, and closer proximity to a traumatic event are      at significant risk for further emotional and behavioral
   crucial factors that increase a child’s risk for developing    distress.

10 • Summer 2018
Although we do not yet know the direct impact of            difficulty adjusting to a new culture which they view as
the recent parent-child separations at the border, and very       harsh or unjust. In addition, many of their parents may
limited research is available regarding family detention          have physical and/or psychological difficulties related to
experiences in the U.S., we can extrapolate data from other       chronic adversity and trauma experienced prior to, during,
studies. Literature in the area of child welfare indicates        and after their journey to the U.S. These mental health dif-
that sudden parent-child separations can be traumatic             ficulties, in addition to the limitations posed by detention,
for some children. Research on immigrant children and             may disrupt parents’ ability to provide safe and enriching
refugees show high rates of PTSD, anxiety, depression,            environments for their children that promote resilience.
suicidal ideation, withdrawal, attention difficulties, and
sleep disturbances in this population (Fazel & Stein, 2002).      What Psychologists Can Do
The American Psychological Association’s Division 27                   While many of us will not provide direct services to
(Society for Community Research and Action, 2016) has             immigrant children and families while they are being de-
stated that the detention of families in prison-like settings     tained, all of us are in a position to advocate for vulnerable
while they await deportation hearings can cause psycho-           populations who are in the care of the U.S. As psycholo-
logical trauma and have long-lasting effects on children’s        gists, we have the unique opportunity to call attention to
physical, cognitive, and psychological development. Given         the long-term psychologi-
these concerns, The American Academy of Pediatrics                cal impact of our country’s
released a Policy Statement on the Detention of Immigrant         treatment of immigrants
                                                                                                   Florida is one of
Children noting that “there is no evidence indicating that        and to endorse govern-           the top 5 states in
any time in detention is safe for children.” (Linton, Griffin,    mental policies that are in
Shapiro, & AAP Council on Community Pediatrics, 2017,             the best interests of chil-
                                                                                                   the U.S. with the
p. 6).                                                            dren and families. Major         largest popula-
      Discoveries from the fields of neuroscience and epi-        professional organizations,
genetics show us that both genes and experiences shape the        including the American           tions of children
structure and function of the developing brains of children.      Psychological Association of unauthorized
Prolonged exposure to stress and adversity can produce            and the American Acad-
excessive activation of stress hormones like cortisol and         emy of Pediatrics have           immigrants (Mi-
adrenaline, which disrupt brain development and the
functioning of other systems (e.g., immune, cardiovascu-
                                                                  spoken out against prior         gration Policy
                                                                  immigration policies and
lar, etc.) over time. When children are in a constant state       their potential to create        Institute, 2018),
of stress or threat, internal resources are diverted away
from such things as reaching developmental milestones to
                                                                  a mental health crisis for
                                                                  immigrant families. They
                                                                                                   making it im-
ensuring their immediate survival. Toxic stress responses         have also called for the         portant for us to
create weak foundations for learning, behavior, and health        thousands of children and
and can cause permanent changes in the brain (Shonkoff et         families currently being
                                                                                                   understand the
al., 2012). Children who are exposed to chronic adversity         detained and/or await-           needs and expe-
and stress are at heightened risk of lifelong mental health       ing immigration hearings
problems, addictions, heart disease, and diabetes.                to receive health, dental,
                                                                                                   riences of these
      Even in the face of toxic stress, the brain has incred-     and mental healthcare that families.
ible plasticity and potential for growth. Healthy brain           meets guideline-based
development in children requires safe, stable, and con-           standards and mitigates
sistent environments, which are most often provided by            harm or re-traumatization (Linton et al., 2017).
supportive caregivers. Returning immigrant children to                 Florida is one of the top 5 states in the U.S. with the
their parents is a step in the right direction to improve their   largest populations of children of unauthorized immigrants
well-being, but is not sufficient by itself to restore children   (Migration Policy Institute, 2018), making it important
to healthy levels of functioning. Although children may           for us to understand the needs and experiences of these
be physically safe when reunited with their parents, it is        families. When providing services to this population, it is
important to recognize that stress has left a lasting impact      crucial that we not only work to understand and respect
on their developing brains and that children may not feel         their cultural values, language, and acculturation, but that
psychologically safe. They are likely worried about what
will happen to them and their families next and may have                                             continued on next page

                                                                                                              Florida Psychologist • 11
The Psychological Impact on Immigration Policies cont’d from page 11

   we utilize a trauma-informed approach to their care that         resources/mental-health-interventions-refugee-children-
   includes the following: 1) acknowledging the impact of           resettlement-white-paper-ii
   trauma in their lives, 2) assessing for signs and symptoms
   of trauma and considering how trauma may be contribut-           APA’s Multicultural Guidelines: http://www.apa.org/about/
   ing to a child or family’s emotional and behavioral pre-         policy/multicultural-guidelines.aspx
   sentation, 3) integrating knowledge of trauma into the
   system of care, and 4) resisting re-traumatization through       References
   the principles of safety, trustworthiness, choice, collabora-    Bonanno, G.A., & Diminich, E.D. (2013). Annual research
   tion, and empowerment (SAMHSA, 2014). Additionally,              review: Positive adjustment to adversity – trajectories of
   in order to provide the most effective interventions for         minimal-impact resilience and emergent resilience. Jour-
   immigrant families, we must also learn about their current       nal of Child Psychology and Psychiatry, 54(4), 378-401.
   acculturative and resettlement experiences, possible anxi-       doi:10.1111/jcpp.12021
   eties related to deportation, experiences of discrimination,
   barriers to care (e.g., limited healthcare coverage, transpor-   Fazel, M. & Stein, A. (2002). The mental health of refugee
   tation issues, stigma, mistrust of systems, etc.), and unique    children. Archives of Disease in Childhood, 87, 366-370.
   strengths and protective factors. And lastly, what we as         doi:10.1136/adc.87.5.366
   mental health providers need to believe in and communi-
   cate to families is hope – hope that through providing them      Linton, J.M., Griffin, M., Shapiro, A.J., & AAP Council
   with evidence-based practices, linkage to resources, and         on Community Pediatrics (2017). Detention of immigrant
   culturally competent care that we can improve their health,      children. Pediatrics, 139(5), 1-13. doi:10.1542/peds.2017-
   well-being, and ability to cope with stress.                     0483

   Resources for Working with Immigrant                             Rosenblum, M., & Ball, I. (2016). Trends in Unaccompa-
   Families                                                         nied Child and Family Migration from Central America.
   NCTSN Refugee Services Core Stressor Assessment Tool:            Washington, DC: Migration Policy Institute. Retrieved
   https://learn.nctsn.org/enrol/index.php?id=62                    from https://www.migrationpolicy.org/research/trends-un-
                                                                    accompanied-child-and-family-migration-central-america
   APA’s Cultural Formulation Interview: https://www.psy-
   chiatry.org                                                      Shonkoff, J.P., Garner, A.S., & The Committee on Psycho-
                                                                    social Aspects of Child and Family Health (2012). Techni-
   NCTSN Resource on Mental Health Interventions for                cal report: The lifelong effects of early childhood adversity
   Refugee Children in Resettlement: https://www.nctsn.org/         and toxic stress. Pediatrics, 129(1), 232-246. doi: 10.1542/
                                                                    peds.2011-2663

                                                                    Society for Community Research and Action (2016).
                                                                    Policy statement on the incarceration of undocumented
                                                                    migrant families. American Journal of Community Psy-
                                                                    chology, 57, 255-263. doi:10.1002/ajcp.12017

                                                                    Trickey, D., Siddaway, A.P., Meiser-Stedman, R., Serpell,
                                                                    L., & Field, A.P. (2012). A meta-analysis of risk factors for
                                                                    post-traumatic stress disorder in children and adolescents,
                                                                    32 (2), 122-138. doi:10.1016/j.cpr.2011.12.001

                                                                    U.N. Refugee Agency. (2014). Children on the Run,
                                                                    Unaccompanied Children Leaving Central America and
                                                                    Mexico and the Need for International Protection. Wash-
                                                                    ington, DC: U.N. Refugee Agency. Retrieved from www.
                                                                    unhcr.org/en-us/children-on-the-run.html.

12 • Summer 2018
RxP Designation Committee Call for Nominations
The American Psychological Association (APA) Board of Education Affairs (BEA) and the Committee for
the Advancement of Professional Practice (CAPP) are seeking nominations to fill two seats on the
Designation Committee for Postdoctoral Education and Training Programs in Psychopharmacology for
Prescriptive Authority (RxP Designation Committee). The appointees will serve a three-year term
beginning Jan. 1, 2018. Committee members shall meet once a year in the fall and may work, as needed,
throughout the year via email and conference calls. The primary task of the committee is to review
applications from training programs in psychopharmacology seeking to be designated by the APA.

The deadline for all nominations is Monday, August 6, 2018. If you are interested in serving on the
committee, or know of someone else who would be qualified for this position, please send nominations,
along with the below-described information, to Kristyn Dempsey. Please note that nominators of other
individuals are responsible for ensuring that these materials are submitted.

Candidate Criteria

We welcome nominations of individuals who have expertise in any of the following domains:

    •   Psychopharmacology postdoctoral program directors.
    •   Basic psychopharmacology science or clinical psychopharmacology research.
    •   Prescriptive authority in psychology.
    •   Prescriptive authority in another health care profession.
    •   Health care system quality assurance.

Other areas of interest are developmental psychopharmacology, integrated health care systems, and
ethnic/cultural factors that can influence psychopharmacological decision-making. The RxP Designation
Committee is composed of one public member seat (currently occupied) and five member seats
comprised of psychologists who are APA members. The committee especially welcomes early career
psychologists (psychologists who are within 10 years of the receipt of their doctoral degree) who
otherwise meet the categories noted above. Appointments to the committee are made jointly by BEA
and CAPP, and confirmed by the APA Board of Directors. Those appointed to the committee will be
notified in writing.

Nominees, if appointed, agree to dedicate the time necessary to fulfill their responsibility to the
committee including but not limited to work between meetings, reviewing documents and applications,
responding to requests from APA staff in a timely manner, and attendance at all meetings.

Candidate Submission Materials
   • Letter indicating the individual’s willingness to serve if selected.
   • 300-word description of qualifications as relates to the areas of expertise noted above.
   • If applicable, indication that they qualify as an early career psychologist (ECP), as defined above.
   • Current curriculum vita.
                                                                                             Florida Psychologist • 13
Vicarious Trauma: Making Meaning of Trauma and
                    the Helping Professional
                       By Juliana Gerena, PsyD; Raven Oshiro, MS; Adriana Ramirez, MS and Taylor Loftus

   D                                         What is Vicarious Trauma?
             uring the last decade, mental                                            cal and sensory changes, which are
             health professionals have           A challenge often arises when        symptoms associated with Post-Trau-
             devoted increasing attention    attempting to derive one specific        matic Stress Disorder (PTSD). As a
   to the negative impact of working         definition for Vicarious Trauma (VT).    result, these experiences may cause
   with traumatized individuals. When        Although VT occurs in multiple set-      significant changes in affect, such as
   providing mental health services to       tings across the world, the definition   depression and irritability, which can
   individuals, the helping profes-                                                     impact the individual’s daily life
   sional engages in therapeutic                                                        interactions as well as impede their
   encounters, which can result in                                                      therapeutic work with clients.
   them being indirectly exposed                                                             Molnar et al. (2017) used the
   to a myriad of stressful events.                                                     term Secondary Trauma Stress
   Helping professionals aim to                                                         (STS) synonymously with VT. The
   establish a therapeutic alliance                                                     authors stated even without direct
   with their clients by express-                                                       exposure to a traumatic event,
   ing empathic bonding, utilizing                                                      helping professionals working
   listening skills, and exhibiting                                                     with traumatized individuals may
   unconditional positive regard.                                                       exhibit symptoms almost identical
   Throughout this process, help-                                                       to those of PTSD, such as intrusive,
   ing professionals are exposed to          can fluctuate, and other descriptions    avoidance, arousal, and emotional
   their client’s trauma, resulting in       are used interchangeably. The term       impairment symptoms. Therefore,
   cognitive, emotional, and behavioral      VT was first introduced in the 1990’s    one person’s exposure to trauma
   changes for clinicians working with       by Pearlman and colleagues who           becomes a traumatic event for the
   victims of a trauma (Craig & Sprang,      described it as the change that occurs   second person involved. Another term
   2010). Thus, the long-lasting expo-       within the helping professional due      used in the literature to describe the
   sure to the distress from the clients     to their empathic engagement when        negative impact of trauma-focused
   who have suffered traumatic events        hearing their client’s narration of a    work, especially among clinicians,
   can lead to the helping professional      traumatic event (Sansbury, Graves,       is Compassion Fatigue (CF). Figley
   becoming emotionally drained and          & Scott, 2014). This change includes     (1995) described CF as a gradual
   burned-out. The literature comprises      cognitive dysfunctions such as dis-      lessening of compassion over time,
   various terms which have been used        torted memories, the development of      resulting in the clinician no longer be-
   to describe the stress resulting from     cognitive avoidance, and generaliza-     ing able to provide adequate services
   working with a person who has been        tions of negative feelings (Sansbury     to the intended population.
   exposed to a traumatic experience         et al., 2014). Therefore, when helping
   including, Vicarious Trauma (VT),         professionals are exposed to VT it is    Prevalence of Vicarious
   Secondary Traumatic Stress (STS),         likely they will respond by detaching    Trauma
   and Compassion Fatigue (CF) (Pearl-       themselves from the situation and or         Prevalence of VT, STS, and CF
   man & Saakvitne, 1995; Schauben &         by distrusting others. Professionals     has been studied more extensively
   Frazier, 1995).                           who are exposed to VT are at risk        among professionals who work with
                                             of developing negative psychologi-       survivors of trauma, including those
14 • Summer 2018
who provide services to victims of          of self-assessment, mental health         may also be a reasonable treatment
a sexual assault, domestic violence         professionals should pay attention        option, particularly for those help-
victims, child or adult protective          to warning signs including difficul-      ing professionals with their own past
services, and advocacy centers within       ties concentrating during sessions,       trauma history (Newell & MacNeil,
the legal system (Molnar et al., 2017).     hostility toward clients, cancelling      2010). Behavioral strategies, such as
Among these populations the preva-          or missing sessions with clients, and     maintaining physical health, bal-
lence of CF and other related condi-        difficulties sleeping (Bamonti et al.,    anced nutrition, receiving adequate
tions fluctuates across areas of exper-     2014). Professionals should strive        sleep, exercise, or recreation, could
tise (Miller & Sprang, 2017). Various       to complete self-assessments of           also serve to buffer the effects of VT
studies have found that 8% to 16%           their emotional wellness and remain       (Newell & MacNeil, 2010).
of graduate students and social works       cognizant of evidence of posttrau-
reported experiencing CF (Adams &           matic symptoms as it is essential to      Impact on Practice and Ethics
Riggs, 2008; Bride, 2007). Whereas          recognize the importance of engaging           The American Psychological As-
other studies found 50% of clinicians       in self-practice behaviors (Johnson et    sociation (APA) Ethical Principles of
treating trauma survivors reported          al., 2014).                               Psychologists and Code of Conduct
experiencing CF (Bride, Jones, &                 Self-care strategies for helping     (hereinafter referred to as the Ethics
MacMaster, 2007; Conrad & Kellar-           professionals include setting realistic   Code) states that psychologists are
Guenther, 2006; Hargrave, Scott, &          goals to manage their workload and        exclusively responsible for ensuring
McDowall, 2006). Similarly, studies         client care, utilizing coffee and lunch   competence to provide therapeutic
on STS in different fields identified       breaks, receiving adequate rest and       services. Specifically, the General
clinical psychologists who work with        relaxation, and maintaining positive      Principles of the Ethics Code reminds
traumatized individuals to have ex-         connections with close friends and        psychologists “to be aware of the pos-
perienced higher levels of STS when         family (Newell & MacNeil, 2010). In       sible effect of their own physical and
compared with other mental health           addition to these self-care practices,    mental health on their ability to help
professionals (Kadambi, & Truscott,         receiving support from professional       those with whom they work” (APA,
2008). The literature on STS has also       colleagues and supervisors may also       2017). The Ethics Code highlights
focused on identifying the severity         serve to decrease the effects of pro-     the importance of psychologists tak-
levels associated with the profession-      fessional burnout (Newell & Mac-          ing reasonable steps to protect their
al’s response to their client’s trauma      Neil, 2010). Considering that burnout     clients when presented with personal
(Elwood, Mott, Lohr, & Galovski,            can result from exposure of extreme       problems, as these instances can
2011). Specifically, clinicians who         cases, it is important to ensure clini-   pose a risk of impacting the profes-
work primarily with traumatized             cians, supervisors, and supporting        sionals’ competence. Specifically,
individuals experience higher levels        agencies work collaboratively to          psychologists who work in hazardous
of STS as compared to other mental          identify symptoms of VT (Sansbury,        or life-threatening settings may be
health professionals (Kadambi &             Graves & Scott, 2014). Specifically,      at significant risk for experiencing
Truscott, 2008; Birck, 2001).               engaging in peer consultation and         trauma-related symptoms, which can
                                            discussing cases with supervisors can     impede their professional competence
How Can Professionals                       provide emotional and social sup-         (Johnson et al., 2014). McCormack
Manage Exposure to VT?                      port as well as normalize the experi-     and Adams (2016) examined the
     It is essential to have professional   ence for the clinician (Johnson et al.,   psychological effects for therapists
awareness of preventive measures            2014). For example, clinicians may        working with complex trauma in an
that can be used individually and           benefit from participating in regularly   inpatient setting. Professionals who
within the work place to prevent VT.        scheduled professional development        participated in this study identified
Newell and MacNeil (2010) defined           activities to enhance competencies        their personal distress, fatigue, and
professional self-care as the utiliza-      (Newell & MacNeil, 2010). Other           self-doubt to have impacted their
tion of skills and strategies by work-      recommendations include engaging          diagnostic approach and professional
ers to maintain their own personal,         with colleagues outside of the work       integrity. In addition, participants
familial, emotional, and spiritual          environment to enhance self-aware-        reported experiencing difficulties
needs while attending to the needs          ness and strengthen social support        maintaining empathy and managing
and demands of their clients. In terms      (Johnson et al., 2014). Psychotherapy                  continued on next page
                                                                                                           Florida Psychologist • 15
Vicarious Trauma: Making Meaning of Trauma cont’d from page 15

   their facial expressions when com-         References                               Kadambi, M. A., & Truscott, D.
   pleting sessions with their patients       Adams, S. A., & Riggs, S. A. (2008).     (2008). Traumatizing aspects of
   (McCormack & Adams, 2016). Thus,           An exploratory study of vicarious        providing counselling in commu-
   highlighting the importance of sup-        trauma among therapist trainees.         nity agencies to survivors of sexual
   porting the ethical obligation to com-     Training and Education in Profes-        violence: A concept map. Canadian
   plete self-assessments and self-care       sional Psychology, 2(1), 26-34.          Journal of Counselling & Psycho-
   practices among psychologists.             doi:10.1037/1931-3918.2.1.26             therapy/Revue, 42, 192–208.
        The importance of establishing
   self-care practices while working in       Bamonti, P. M., Keelan, C. M., Lar-      Miller, B., & Sprang, G. (2017).
   the mental health field has become         son, N., Mentrikoski, J. M., Randall,    A components-based practice and
   increasingly recognized, however,          C. L., Sly, S. K., & ...McNeil, D. W.    supervision model for reducing com-
   there is limited research on identify-     (2014). Promoting ethical behavior       passion fatigue by affecting clinician
   ing the importance of self-care prac-      by cultivating a culture of self-care    experience. Traumatology, 23(2), 153
   tices among psychologist (Bamonti          during graduate training: A call to      164. doi:10.1037/trm0000058
   et al., 2014). Although research has       action. Training and Education in
   identified graduate students to report     Professional Psychology, 8(4), 253-      Molnar, B. E., Sprang, G., Killian, K.
   experiencing high levels of distress,      260. doi:10.1037/tep0000056              D., Gottfried, R., Emery, V., & Bride,
   a greater emphasis should be placed                                                 B. E. (2017). Advancing science and
   on employing self-care practices           Craig, C. D., & Sprang, G. (2010).       practice for vicarious traumatization/
   among psychology and mental health         Compassion satisfaction, compassion      secondary traumatic stress: A research
   graduate training programs (Bamonti        fatigue, and burnout in a national       agenda. Traumatology, 23(2), 129-
   et al., 2014). By promoting a culture      sample of trauma treatment therapists.   142. doi:10.1037/trm0000122
   of self-care practices for profession-     Anxiety, Stress & Coping: An Inter-
   als early in their career, it may help     national Journal, 23(3), 319-339.        Newell, J. M., & MacNeil, G. A.
   future mental health professionals es-     doi:10.1080/10615800903085818            (2010). Professional Burnout, Vicari-
   tablish healthy behaviors, which may                                                ous Trauma, Secondary Traumatic
   foster wellness and reduce the risk of     Figley, C.R. (1995). Compassion          Stress, and Compassion Fatigue: A
   impairment in the future. Psychology       fatigue as secondary traumatic stress    Review of Theoretical Terms, Risk
   training programs and practicum sites      disorder: An overview. In C.R. Figley    Factors, and Preventive Methods
                                              (Ed.), Compassion fatigue: Coping        for Clinicians and Researchers. Best
   should encourage students to engage
                                              with secondary traumatic stress dis-     Practice In Mental Health, 6(2), 57-
   in self-care behaviors and to regularly
                                              order in those who treat the trauma-     68.
   monitor their own physical, mental,
   and emotional wellbeing. In addi-          tized (pp. 1-20). New York: Brunner/
                                              Mazel.                                   Pearlman, L.A., & Saakvitne, K.W.
   tion, Bamonti and colleagues (2014)
                                                                                       (1995). Trauma and the therapist:
   proposed that the APA should clearly
                                              Harrison, R. L., & Westwood, M. J.       Countertransference andvicarious
   define self-care as part of the train-
                                              (2009). Preventing vicarious trauma-     traumatization in psychotherapy with
   ing process for graduate programs to
                                              tization of mental health therapists:    incest survivors. New York: W.W.
   enhance performance among train-
                                              Identifying protective practices.        Norton.
   ees. Finally, from an ethical point of
                                              Psychotherapy: Theory, Research,
   view, self-care practices should not                                                Sansbury, B. S., Graves, K., & Scott,
                                              Practice, Training, 46(2), 203-219.
   be implemented only in the event of                                                 W. (2015). Managing traumatic stress
                                              doi:10.1037/a0016081
   distress or impairment. It is important                                             responses among clinicians: Indi-
   to understand that self-care practices                                              vidual and organizational tools for
                                              Johnson, W. B., Bertschinger, M.,
   are necessary not only for those who                                                self-care. Trauma, 17(2), 114-122.
                                              Snell, A. K., & Wilson, A. (2014).
   are having difficulty managing the         Secondary trauma and ethical obli-       doi:10.1177/1460408614551978
   demands of training and working in         gations for military psychologists:
   the mental health fields, but continual    Preserving compassion and com-           Schauben, L.J., & Frazier, P.A.
   self-care practices are critical for the   petence in the crucible of combat.       (1995). The effects on female coun-
   promotion of wellbeing.                    Psychological Services, 11(1), 68-74.    selors of working with sexual
                                              doi:10.1037/a0033913                     violence survivors. Psychology of
                                                                                       Women Quarterly, 19, 49-64.
16 • Summer 2018
Florida Psychological Association
                                  Call for Nominations
Rules:
1. You may nominate only one (1) person for each office. Self‐nominations are acceptable.
2. A nominee must receive ten (10) nominations in order to be listed on the final ballot.
3. Only Regular, Federal, Active‐Duty Military, Semi‐Retired, Senior Psychologist and Retired FPA
members in good standing as of July 1, 2018 may run for office or submit nominations. Associate, out‐of‐
state, affiliate and student members are not eligible.
4. You may only submit one nomination form ‐ subsequent forms shall not be counted.
5. Nominations must be received by Friday, August 3, 2018 at 5:00 pm EDT to be counted.
6. To be eligible for nomination as an FPA officer at the state level, the nominee must have held a
leadership position in a division, special interest group, or chapter as an officer, chapter representative to
the Board of Directors, or member of a FPA chapter or state‐level standing board or committee for no less
than one year.

              Nominations must be received by Friday, August 3, 2018 at 5:00pm EDT.

                  I wish to nominate the following individual(s) for FPA office:
FPA President‐Elect, President‐elect term commences January 1, 2019; Presidency in 2020;
and Immediate Past President in 2021.
Name of Nominee:
FPA Treasurer, 2‐year term. Term commences in January 1, 2019 and expires December 31,
2020.
Name of Nominee:

Nominated by:
      (Required – Print legibly or type. If we cannot read your name the nomination will not count.)

Your Signature: ______________________________________________________
                       (Required ‐ The form will not be counted without a signature.)
                     Received no later than Friday, August 3 at 5:00pm EDT.
                      MAIL or FAX to:        FPA Nominations
                                            408 Office Plaza Drive
                                            Tallahassee, FL 32301
                                            FAX: 1 (850) 344‐9085
                      Email to:             carolyn@flapsych.com

                                                                                                     Florida Psychologist • 17
Using Mindfulness to Treat Smoking:
                            The iPhone/iPad Application
                   By Michelle Blose, MS, Nova Southeastern University, Bay Pines VAHCS Neuropsychology Intern

   Smoking: What’s the Issue?                 cessation. Mindfulness Training           treatment. Additionally, MT may be
        Smoking causes heart disease,         (MT) has begun to show benefits in        effective as a treatment for smoking
   cancer, respiratory illness, and other     a number of psychiatric disorders,        cessation and informal mindfulness
   medical conditions (Fichtenberg            including depression, anxiety and         practice predicts a decoupling of
   and Glantz, 2002). In 2010, 20.2%          more recently, in addictions (Brewer      the association between craving and
   of adults in the United States were                                                  smoking (Elwafi et al., 2013).
   current smokers and 25.2% used any                                                       For smoking cessation,
   tobacco product, such as smokeless                                                   mindfulness may help one manage
   tobacco, water pipes, or cigarillos                                                  nicotine cravings or feelings of
   (Ablah, Dong, & Konda). Tobacco                                                      withdrawal when quitting smoking;
   use continues to be the leading cause                                                reduce stress, anxiety, and depression;
   of preventable death in the United                                                   increase positive emotions and
   States. While numerous individuals                                                   enjoyment in daily life; encourage
   do not smoke, at least 53,000 non-                                                   healthier eating habits; and improve
   smokers die each year due to second                                                  relationships. “MT may help
   and third hand smoke. Third hand                                                     individuals learn to ‘sit with’ negative
   smoke refers to the chemicals in                                                     effects, cravings, and withdrawal
   cigarette smoke that settle on the                                                   without habitually reacting to these
   surfaces inside a home or on clothing                                                unpleasant states by smoking”
   (Burton, 2009). In brief, this means,                                                (Brewer et al., 2011).
   that for approximately every eight         et al., 2011). Brewer and colleagues
   smokers, one non-smoker dies.              (2011) found that their initial trial     The iPhone and iPad
   Mainstay behavioral treatments for         of MT may confer benefits greater         Application
   smoking have focused primarily             than those associated with current             The Craving to Quit! iPhone
   on “teaching individuals to avoid          standard treatments for smoking           application is a three-week self-
   cues, foster positive affective states,    cessation. Moreover, treatments that      directed program available for both
   develop lifestyle changes that reduce      target both affective states as well as   iPhone and iPad that incorporates
   stress (e.g., practice relaxation),        cravings, may be helpful in smoking       research on mindfulness training. The
   divert attention from cravings,            cessation (i.e., MT). “Mindfulness        application was created by Dr. Judson
   substitute other activities for            approaches have been operationalized      Brewer, former medical director
   smoking, learn cognitive strategies        to include two components: (1)            at Yale Therapeutic Neuroscience
   that reduce negative mood, and             maintaining attention on the              Clinic. Every day, with the
   develop social support mechanisms”         individual’s immediate experience         application, the individual states how
   (Brewer et al., 2011, p. 2).               and (2) maintaining an attitude of        many cigarettes he or she smoked.
                                              acceptance toward this experience”        Also, there is a “Want-O-Meter” on
   Use of Mindfulness Training                (Bishop et al., 2004). Those who          the application where the individual
                                              have received mindfulness training
   for Tobacco Use                                                                      states how badly he or she wants a
                                              have shown a greater reduction            cigarette and then what triggered
        It is believed that mindfulness
                                              rate in smoking, which lasts over         the craving. It then gives different
   is a potential moderator to smoking
18 • Summer 2018
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