Am I blind to the fact that the nosology of psychiatry/psychology requires this distinction? I don’t think so, and I question using a word that appears to have evidence of its biological or “unconscious” base.

Yes, biology is often seen as the cause of so many mental disturbances, but we are still walking in a dark room with our eyes shut on that one. For every “discovery” about a gene connection, we find it’s a dead-end where treatments fail, yet we continue with the treatments as though they will provide a cure. Some of the treatments bring on more symptoms that then require another treatment. Consider the rash of TD (tardive dyskinesia) medications we’re now seeing on TV. It is an iatrogenic disorder.

Today, my substack is prompted by reading about play therapy, its effectiveness, and where it originated. I believe it has a place in treatment for children, but I am also aware of the warped history that came before it.

One of the significant forces that sparked interest in this form of treatment was the Virginia Axline book “Dibs in Search of Self….” Greeted enthusiastically by the public and professionals alike, I don’t believe many looked critically at Axline’s portrayal of her treatment and the boy. I think it’s similar to the case of the Sybil books. Authors can take some liberties with their books, but not when people’s lives are at stake.

I’ll give one example of a problem with Axline’s book. Axline stated the therapeutic intervention lasted six months. I understand it took much longer than that, possibly years, and I have to ask if Axline or her editors made that change in the book. The second point is Axline’s theoretical basis for her interventions, both of which she fails to outline in her book. It’s more of a diary than anything else.

What prompted her to conceive her approach? The critical readers of her book have pointed out that she subscribed to the original idea of the “refrigerator mother.” Cold, emotionally distant mothers were the genesis of the syndrome. One of the strong proponents of this orientation was Bruno Bettelheim, a man discredited for plagiarism after his death when research regarding his book on fairy tales and, allegedly, brutal therapeutic treatments came to light. His book, “The Empty Fortress..” lays the blame for autism squarely on mothers.

Bettelheim appears to have had no training or credentialing in the techniques he espoused and may have given himself a c.v. that was replete with falsehoods. The image he created has been repeatedly questioned, and it is astonishing. Despite all of this, too many hold him in high regard.

Of course, the journal he wrote while in a German prison camp is something we should read. But, considering his slipping into unverified rhetoric, we have to question that, too.

Aside from Freud, Bettelheim, and Axline, we need to, as is being done now, begin the work of repair on theory and treatment of mental disorders. If they are illnesses, let’s say what causes them and, if they are more dependent on environmental issues, okay. More likely, any disturbance is multi-factorial, and many treatments will still not hit the mark solidly enough to “cure” these illnesses. As one patient told me, relief from his auditory hallucinations was what he wanted.

The future is bright and promising in terms of neurobiology and psychological treatments and, for that, we should be grateful. One instance of a book where I believe we can take comfort in parents’ ability to help autistic children is “Son Rise,” written many years ago. I recommend you read how dedication and consistent hard work with a child can have incredible results.

Remember that we create “gods” in medicine and psychology, and too many of them have feet of clay. Psychology has a few presently running around beating their chests like prominent warriors in the war for mental health treatments. But they may provide a crumb of an idea that can be extended to something worthwhile. Worshipping them without recognizing their humanity takes the wrong road on a dangerous highway.

The post Old Theories, Questionable Experts, and Mental Disturbances Need to Be Deconstructed appeared first on Medika Life.

The Steven A. Cohen Military Family Clinic at Metrocare is a non-profit mental health clinic serving veterans and their families throughout North Texas. The Addison clinic previously offered couples and group therapy to active duty servicemen and women. This expansion of services announcement opens the door for any active-duty personnel to seek individual treatment.

Veterans and active-duty members face a variety of potential mental health challenges. Like civilians, Covid-19 has exacerbated these life stressors.

Metrocare providers have been offering North Texan veterans evidence-based care since 2016 for a wide range of mental health challenges. Help is available for depression, anxiety, and post-traumatic stress. Other families seek help for adjustment issues, anger management, and grief counseling. The clinic also provides therapy for service members struggling with family issues and relationship problems. The family-friendly environment also provides care for children.

The Cohen Clinic at Metrocare also offers case management services to connect veteran families to community resources and services.

The Addison clinic is nearing its fifth anniversary serving the community. This office is one of the original sites of the now nationwide Cohen Veterans Network (CVN). Military families now can get the help they need at one of the 19 Steven A. Cohen Military Family Clinics across the country.

Clinic Director Dr. Amy M. Williams highlights the need to provide mental health care throughout the continuum of military service, stating, “By including the individual active duty service members, we can begin to address problems closer to their onset instead of waiting until after service discharge. Providing timely and effective mental health care strengthens our military and, ultimately, our veteran population.”

The Cohen Clinic is partnered locally with Metrocare, the largest behavioral health services provider in Dallas County. Together, they have served over 2,000 North Texas veterans and family members.

To reach more people in need, The Cohen clinic builds on existing partnerships with the Department of Defense, the VA, and veteran service organizations (VSOs) throughout North Texas. The VA offers specific tools to help veterans cope with the challenges of the Covid-19 pandemic. They acknowledge making the transition to civilian life was already difficult. The pandemic adds to the stress and mental toll.

The 2020 National Defense Authorization Act authorized the Department of Defense to find community-based care for veterans if DoD could not arrange an internal referral. The Cohen clinic fills the void for our service members making the transition to civilian life.

The Covid-19 did not stop the Cohen Clinic at Metrocare from providing mental health treatment access. Telehealth and virtual care access continued through the CVN Telehealth platform. Virtual therapy options expanded access for service members in various military installations across the Dallas Fort Worth Metroplex.

As in-person visits resume the clinic plans to restart its Military Family Clinic Classes to help provide holistic and comprehensive care to the entire family.

Improving access is an essential step in caring for those who serve in the Us military. Data from 2012 showed veterans reported severe psychological distress more often than nonveterans, but less than 5% report the distress. Public health experts now prioritize the well-being of military personnel and their families.

Any active-duty service member is eligible for care with a Tricare referral.

For more information, check the company website: Cohen Veterans Network news release.

Learn more about the Cohen clinic’s mission and values here.

The post The Cohen Clinic Expands Mental Health Treatments for Active Duty Service Members appeared first on Medika Life.

The purpose of the article is to explore the benefits of performing a therapist-client or coach-coachee survey. Next, I look at why defining private practice goals allows a pathway to measure assessment feedback against. I look at a potential set of criteria to define the client assessment. Finally, the article investigates what available applications exist in the market today to solicit, gather and make sense of the data. We have a lot to unpack; let’s get started. 

The Background

At this moment, I see an absence of therapists and coaches requesting performance assessments from their clients — unless the practitioner takes matters into their own hands. Let’s examine the challenge through a personal example. 

All students who study Gestalt Psychotherapy must accumulate 50 hours of therapy with a more experienced Gestalt practitioner before the end of Year 3. Through this process, the therapist-in-training gains client hours towards becoming certified while I, the client, can witness firsthand the use of Gestalt in action. The therapist-in-training must write detailed notes regarding their client experience and submit the forms to the Gestalt faculty for review through their mentorship program. All of this sounds great. Except I see one fundamental flaw. 

Where is the voice of the client providing feedback on their experience with the therapist? How will the therapist know if they are truly supporting the needs of their clients?

The current method allows the Gestalt therapist to provide their inherent bias on the quality of the interaction with the client rather than allowing a holistic client-therapist-program feedback loop. When writing this article, I am engaging with Gestalt faculty on this critical question and will update the notes section once I have answers. 

Define Your Goals For Private Practice 

I believe in the importance of goal setting, even when establishing a psychotherapy or coaching practice. Knowing your goals will allow you to measure against them and to adjust and pivot based on client feedback. Examples of goals statements may include:

• I desire to work with people who possess a burning passion for change.
• My client base will remain small and focused, allowing for five people at a given time. 
• I will strive to be present and available at all times during client conversations.

While the above statements are not concrete, the qualitative nature will allow me to measure whether change over some time will occur for clients, what it is like to have a small base of people to work with, and whether others perceive my ability to be present. For those of you who are already seeing clients, do you have goals? Are your original goals the same as they are today? 

Criteria To Assess Client Impact

Like so many before me, in the Fall of 2021, I will find myself a part of the Gestalt student clinic and work with clients in the earlier stages of their psychotherapy learning career. The difference is — I’m from the corporate world and understand the value of data and analytics; in particular, my fascination lies in how data tells a story. Based on my personal experience, the following questions emerge:

• How can I utilize qualitative data from my clients to gauge overall performance? 
• How can I engage with clients in a friendly, engaging way to solicit feedback while avoiding a cold, factual approach?
• How often should I extend outreach to clients? What is the healthy balance to obtain just enough feedback promptly?
• Based on the data, where are opportunities to pivot?
• How can I evolve my practice to ensure I am at my best in every interaction? 

Through this lens, the following sample assessment criteria are under consideration and applied to therapists and coaches. 

•  In what ways can the therapist-client relationship be strengthened? 
• Trust is the foundation upon which the therapist and client perform the work. Are there ways to further develop and strengthen trust in our sessions? 
• Do you have an interest in exploring other ways to collaborate during therapy sessions? And if so, what activities do you gravitate towards?
• In our initial sessions, we established a Design Alliance. Are there areas we need to refine to improve our mutual approach? 
• How likely are you to recommend psychotherapy services to a friend or family member?

Once the assessment criteria are more formalized and data gathered, my objective is to ensure the results are transparent on my website. Honesty and integrity are building blocks of private practice, and I believe this behavior has a powerful appeal for others seeking therapeutic or coaching services. 

Applications To Obtain Client Feedback

Online surveys and options to request client feedback are plentiful. The following list is courtesy of Zapier and amended for this article: 

• SurveyPlanet for beginners.
• Typeform creates visually appealing surveys.
• SurveyMonkey for creating surveys on a phone or tablet.
• LimeSurvey for self-hosted surveys.
• QuickTapSurvey for offline surveys.
• YesInsights for one-click surveys.
• Surveybot for chatbot surveys on Facebook.
• SmartSurvey for collaborating on survey questions.
• SurveyGizmo for optimizing your surveys.
• Constant Contact includes helpful survey builders.

To Conclude

The article explores the importance of possessing clear goals to operate a therapy or coaching practice. Over time, collecting qualitative data from clients will demonstrate the quality of therapeutic sessions and showcase areas where I excel and others where I need to pivot and improve. If any readers have direct experience gathering client data in your therapy or coaching practice, please reach out; I will love to learn best practices as I get closer to opening a private clinic. 

The post How Do Therapists And Coaches Know If They’re Impacting Clients? appeared first on Medika Life.

The experience I have had is that once you start talking about [experiencing a mental health struggle], you realize that actually you’re part of quite a big club. — Prince Harry

The COVID-19 pandemic is extremely stressful and has more victims than those lying in beds or graves; it has mental health problems and stigma. Why stigma?

The question of mental health and receiving psychotherapeutic treatment has always carried with it an element of stigma. Those with any mental health issues were berated, isolated, or laughed at with impunity. Often, the village idiot was someone with a mental illness.

Now, mental health issues have grown exponentially not only in the general population of all countries but also in their healthcare staff. And it is also in healthcare and law enforcement where discussion of mental health problems is verboten.

Jobs depend on mental stability, and too often, those in medicine or law are expected to be extraordinary individuals who are impervious to any suggestions of mental difficulties. Admitting to the stresses of the job during a pandemic is not expected or encouraged.

The refusal to accept the need for mental healthcare in medical professionals has led to breakdowns with tragic results as detailed in physicians’ suicides. But, in some countries, like China, the reluctance to seek mental healthcare during any time has been strongly supported by the culture.

In this study, a significant proportion of participants experienced anxiety, depression, and insomnia symptoms, and more than 70% reported psychological distress. In a previous study during the acute SARS outbreak, 89% of health care workers who were in high-risk situations reported psychological symptoms.

The full impact of the psychological toll on the citizens and the professionals resulted in China’s surveys of their needs and how to respond to them.

Mental health hotlines were quickly established across China and provided the public with counseling and psychological services. The telephone and Internet have been widely used to deliver mental health care services, and social media platforms (e.g., WeChat, Weibo) have been used to share strategies, guidelines, and education programs for managing potential mental distress.

In addition, a series of self-help handbooks for psychological care associated with COVID-19 have been published by the China Association for Mental Health, medical institutions, and universities.

According to the World Health Organization, there are nine therapists for every 100K people in China. The need may be great, but the lack of therapists tells how psychotherapy is viewed in the country. Who would enter a profession where patients refused to come to you?

Laws in China, which poorly define psychotherapy, but carry restrictions and deny anyone the right to be called a psychologist, are facing pushback by people in need. Now, the pandemic has only increased the need for services.

China Is Not Alone in Denying Mental Health Needs

When I was a doctoral student in New York City, another student in my peer group brought up a distressing situation for discussion. He was trying to offer services to his NYC community of Orthodox Jews and realized it was more than he could handle.

Rather than take mentally ill members of the community for psychological or psychiatric services, parents often kept the individual locked in a room. This would go on for years sometimes.

In recent years, numerous efforts have been made to address the stigma in the Orthodox community, where the fear of harming marriage prospects has drawn a curtain of secrecy around those suffering from mental illness.

Since that time, things have changed, but it may not be the case in all religious communities worldwide. Some societies see the mentally ill as possessed of a devil, others as touched with special powers. Would this person need a psychologist or a preacher?

I worked in a psychiatric hospital where a patient told me a nurse said he should fast to cure his schizophrenia. He already believed that he was suffering because of some sin he had committed. Now, she told him that was true, and he needed to pray, too. This was not an unusual case.

Visitors came onto a unit at another psychiatric hospital and performed repeated exorcisms with or without staff knowledge. One patient, after three exorcisms, told them to stop it.

Admitting to Our Humanity

The term “No one’s perfect” is surely the case because, if we were, would we be human? Even bots aren’t perfect, yet we think we can make them into perfection personified. We program them to be careful listeners and do work similar to therapists. Is that a good thing or yet another problem?

Our foibles make us who we are, and perfection may not be what we want or need. What we want is to be understood, accepted, and helped when we need help.

Algorithms can’t ask for help, but we can, so we’re better than the bots that are seen as performing yet another human task and doing it well.

Destigmatizing psychotherapy and mental health disorders has to be job #1, and we need to do it quickly, and the therapy has to be effective. We can teach people new behaviors and ways of approaching difficulties and to accept that none of us is invulnerable.

And we need to admit our powerlessness sometimes. But belief systems aren’t always easily fixed, but that doesn’t mean we should give up.

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