Clinical Dialog

Life is getting ever more complex.  People are relocating and want to retain their clinician.  People live in rural areas and have trouble finding a provider.  People have a problem they are hesitant to bring forward.  Does on-line therapy have a place in our practice lives?  Can we Skype our way to health or IM our symptoms?
Read the article below that was highlighted on CNN for some interesting perspectives.

http://www.cnn.com/2009/HEALTH/08/31/online.internet.therapy.cbt/index.h...

The DSM-V is getting a lot of press at this time.  Bringing new diagnoses into its pages creates much debate.  The concept of obesity as a mental illness has been considered within the broader category of Eating Disorders but does it actually qualify?

Have you ever felt threatened by a client? Our profession is fraught with dangers of various kinds, but the risk of falling victim to personal violence does exist.  According to Ethics in Psychotherapy and Counseling: Third Edition, 5% of psychologists have reported being physically attacked by a client and 80% of the population of psychologists they studied indicated they felt threatened.  This article cites 39 sources of information on what, why, who and how.  It may just be worth your while to self-inform and then review your activities.  Are you high risk or low?

Doc Warren, who shared his thoughts on documentation with us in October, is back to give us a primer on marketing on a shoestring.  In today's economy, many clinicians are either trying to expand income with part-time practices or to lower the costs for the practices they presently have. This article gives some great ideas on establishing a web site as well as inexpensive devices for further marketing your services.  Word of mouth or bespoke is still a wonderful sales tool, but a more youthful demographic wants you a touch away on their blackberry.

If you have never taken an Implicit Association Test, try it now.  In fewer than ten minutes you can check out your own biases. 

Studies have indicated that variables or traits that are commonly associated with one gender or another, or one race or another, are actually negligible.  But that might not be indicative of our assumptions, and our assumptions drive our therapeutic endeavors.  Step up and see how you compare to the very large cohort tested using this instrument.

http://www.understandingprejudice.org/iat

Pete Walker, MFT offers a plethora of information on the impact of childhood emotional abandonment and its possible outcome of adult complex PTSD.  Exploring the angry reactions against the self or others that express in emotional flashbacks, he suggests ways of dealing with the toxicity of the merging of the client with the internalized critic.  Looking at fear, shame and feelings of defectiveness, he elucidates the arduous task of helping these clients experience acceptance as well as educating them to identify behaviors of fighting, fleeing, freezing and fawning.

Much debate has arisen around the issues on the usefulness of diagnosis. Studies indicate that many of the syndromes elucidated in the DSM IV have not been subject to empirical analysis. The burden of validity is based on 5 criteria, according to the article below, and many of our diagnoses don't hold up.

The popularity of social networking is a reality not many of us can ignore. For those of us with a client population under the age of 40, we may be fielding requests to allow access to us via Facebook, Linkedin, Twitter or Skype. The generational differences are enormous, with adolescents barely able to relinquish access during a therapy session.

For many of us, this disorder doesn't present itself frequently in our client populations. The statistics reveal that 3.5% of females and 1.5% of males suffer in silence with this illness, often in shame and embarrassment.

Dream Interpretation

The New York Times, in a recent article, reawakened our interest in dreams. Is this the newest or oldest method of virtual reality? Studies are continuing to explore this subconcious/unconcious process available to all of us to approach our emotive memories and to seek solutions to current dilemmas.  Read this recent article and then, if you have the time, explore the two dream-readers from the past: Freud and Jung. The two sites listed following the Times, are synopses of Freud and Jung's theories on interpretation.