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PRESCRIPTION PRIVILEGES MAKE SOME PSYCHOLOGISTS ANXIOUS
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The APA has spent more than $1 million to help state psychological associations develop and lobby for such prescription privileges -- or "RxP" -- legislation.
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A total of 31 state psychology associations have task forces dedicated to developing and lobbying for prescription-privileges legislation.
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The version endorsed by the APA would license doctoral-level psychologists to independently prescribe psychotropic drugs after completing 300 hours of classroom instruction in neuroscience, physiology and pharmacology, followed by four months' supervised treatment of 100 patients.
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Critics say that is not nearly enough compared with other prescribers, such as M.D. psychiatrists or nurse practitioners who have at least six years' medical education and clinical experience.
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Neither Davison nor most other RxP opponents doubt the efficacy of medications.
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Their greatest objection is to the notion of turning psychology into a prescribing profession.
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In a field that has struggled long and hard to prove that mind, mood and behavior can be studied empirically, the past decade, Davison says, has seen "exciting developments" that demonstrate the validity of various psychotherapeutic interventions and the psychosocial-behavioral models on which they are based.
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"exciting developments"
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"The timing is peculiar to abandon psychological science or to convert it to a medical science,"
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"The timing is peculiar to abandon psychological science or to convert it to a medical science," explains Elaine M. Heiby of the University of Hawaii, who chairs a committee of the 1,000-member American Association of Applied and Preventive Psychology that is concerned about the medicalization of psychology.
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(ATTENTION EDITORS: This article is for use by clients of The New York Times Syndicate's SCIENTIFIC AMERICAN NEWS SERVICE.
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RxP opponents charge the APA with pushing its prescription-privileges agenda without adequately assessing support for it in the field.
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The 300-member SSCP is the only group within the APA to have taken a formal stance against prescription privileges.
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The APA has scheduled 30 minutes at its meeting in August for an RxP debate, but its leadership believes it already has an accurate sense of support for its RxP policy.
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For information about becoming a client of this service, contact the New York Times Syndicate sales representatives listed at the end of the text.)
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"Except for this small vocal minority, we have just not gotten a lot of groundswell against this from members,"
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"Except for this small vocal minority, we have just not gotten a lot of groundswell against this from members," says APA president Philip G. Zimbardo of Stanford University.
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With prescription privileges now a reality in one state, some RxP opponents concede that it may be too late.
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This year four states besides New Mexico -- Georgia, Hawaii, Illinois and Tennessee -- have pending legislation for psychologist prescription privileges.
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Over the past decade, 14 state legislatures have considered such laws.
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Between 1991 and 1997, a U.S. Department of Defense psychopharmacology demonstration project involving two to four years' training produced 10 military psychologists who can write prescriptions.
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For more information on the topics covered in the Scientific American News Service, visit www.sciam.com.
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Intending to ease consumer access to mental health care, New Mexico legislators in March passed a law allowing psychologists to prescribe psychotropic medications, such as antidepressants.
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The state's action, the first in the nation, has the blessing of the American Psychological Association (APA), which considers prescriptive authority a logical extension of psychologists' role as health-care providers.
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What matters, he believes, is that his generation thought the bomb should be dropped.
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"We were not bloodthirsty guys,"
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"We were not bloodthirsty guys," he said.
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"We were convinced then, and I still am, that we ended the war a year or two earlier.
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And what the casualties would have been, who knows -- but heavy."
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"On Tinian, and probably elsewhere, the Seabees were building enormous hospitals while we were there,"
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"On Tinian, and probably elsewhere, the Seabees were building enormous hospitals while we were there," he said.
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"Those hospitals were not for us.
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They were for (an expected invasion of Japan).
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And then the casualties were going to be terrible."
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Karnes carries the image of hundreds of hospital beds in his mind.
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In his heart, he holds the unshakable conviction that the mission he helped organize saved America from disaster.
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"This is a Silverplate request,"
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"This is a Silverplate request," he said.
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Denise Gamino writes for the Austin (Texas) American-Statesman.
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Silverplate: code word for the historic mission that would end World War II.
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Almost 1,800 men were assembled n late 1944 to join the top-secret unit called the 509th Composite Group.
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Col. Paul Tibbets, the pilot who would drop the world's first atomic bomb over Hiroshima, Japan, was commander of the unit and chose the men.
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A mission to end a war
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And the first person he chose to join him was Karnes, though he couldn't reveal the mission to Karnes.
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Karnes, 87, is a retired history professor who lives in suburban Austin with his wife, Virginia, who also worked for the 509th as a civilian bookkeeper for six months.
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Karnes was Tibbets' adjutant, the man in charge of writing the orders and cajoling the transfer to the unit of servicemen proficient in bombing, mechanics, ordnance, engineering and communications.
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Tibbets hated paperwork.
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Karnes thought it was a breeze.
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They were a wartime match that changed the world.
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Japan surrendered within days of the detonation of the atomic bombs that killed 140,000 people in Hiroshima on Aug. 6, 1945, and 70,000 in Nagasaki three days later.
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AUSTIN, Texas -- Tom Karnes was dialing for destiny, but not everyone wanted to cooperate.
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The story of the 509th is a tale of an elite outfit that lived in a bubble of secrecy and endured the taunts of other war-weary U.S. units that resented sharing a small Pacific island with the 509th, which appeared exempt from combat.
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Tinian Island was the staging area where the 509th moved after its creation in the desert.
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Karnes has never spoken publicly about his role as Tibbets' right-hand administrative aide.
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He never even told his story to students in his 40 years of teaching college.
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War is hell, he says, and when it was over, he wanted to come home and rejoin his young family and not dwell on it.
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He earned a doctorate in history from Stanford University and taught Latin American history at Tulane University and Arizona State University.
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Next week marks the 57th anniversary of the atomic bombings.
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Karnes sat in his wood-paneled office in a Quonset hut in the middle of the Great Salt Lake Desert, a black telephone to his ear.
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Each year on Aug. 6, "I always think of Paul Tibbets and how he handled unbelievable responsibility," Karnes said.
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Karnes met Tibbets when the 29-year-old bomber pilot walked into Karnes' office at Wendover Army Air Field on the Utah-Nevada border.
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Karnes was the personnel and classification officer.
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He was only a captain, but he had been left in charge at Wendover the day Tibbets surprised them by landing a B-29, a new plane no one at Wendover had seen.
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Tibbets had just been ordered to organize a combat force to drop a bomb being developed by a secret enterprise known as the Manhattan Project.
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He was searching for a remote installation to train bomber crews and support units in total secrecy.
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Tibbets instantly liked the isolation and vast size of Wendover and the surrounding Bonneville Salt Flats.
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And he immediately liked Karnes, who showed him around the base.
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Both were smart, disciplined, quiet men who thrived on efficiency, perfection and self-reliance.
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Each had skills the other admired.
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He was tracking down men to join a group so secret he couldn't admit it existed.
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"I don't recall ever having to tell Tom to do anything,"
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"I don't recall ever having to tell Tom to do anything," Tibbets said in an e-mail this week.
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"He was so knowledgeable he just got things done, allowing me to concentrate on other matters.
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"
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Tibbets quickly returned to Wendover after that first visit to set up his headquarters.
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His first order appointed Karnes adjutant for the 509th.
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Almost overnight, Wendover became a high-security base filled with off-limit areas covered in barbed wire.
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No one was allowed to talk about what they saw or heard, even though most of the 509th had no idea why they were there, except that 15 B-29s were being modified to carry a heavy load.
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Karnes and his staff read outgoing mail to make sure no secrets slipped out.
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Phone calls were monitored.
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An undercover force of Manhattan Project security agents infiltrated the base and bars in the little town of Wendover (population 103) to spy on airmen.
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Karnes knew the 509th was preparing for a special bombing mission, but he had no idea what kind of bombs were involved.
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"I had a friend, the finance officer.
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He said that they had split the atom and that we were going to drop an atomic bomb," Karnes said.
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"I said, `No."'
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A noncommittal "mmm-mm," was the most Karnes could ever get out of Tibbets on matters of the bomb.
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"mmm-mm,"
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By spring, the 509th prepared to move to Tinian Island, near Guam and Saipan.
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That would put the B-29s about 1,500 miles from Japan -- a 13-hour round-trip flight.
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Karnes was deluged with orders for inoculations, equipment, transfers and promotions.
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He was calling bases all over the United States to line up their transfer to the desert outside Salt Lake City.
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Karnes arrived on Tinian on May 18, 1945, as part of an advance team that flew in the five C-54 transport planes of the 509th.
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On May 29, 1,200 men arrived on the troopship Cape Victory after a five-week trip from Seattle.
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Tinian Island had been captured from Japan, and the Seabees, the construction arm of the Navy, had built two large airfields.
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The 509th took North Field and stayed in relative isolation from other B-29 units on the island.
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Karnes had his own Jeep, and went to the beach and to evening movies shown by other units as often as he could.
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Not until the day before Tibbets and his crew flew to Hiroshima was the 509th told what was happening.
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The word spread: "This is it.
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"This is it.
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