mreeder

HI -- I'm wondering:

1. If support for private communities with a restricted member list within a Lemmy instance that is otherwise public is on the drawing boards for future implementation? Timeframe? Or just a someday since we are mostly volunteers?

2. If not, where would be the best place for me to submit this feature request?

Trying to weigh several factors as to whether or not to keep my Lemmy instance operational. My use case is I'm trying to attract an audience of users (mental health professionals) who seem to be just not interested in discussions on Lemmy if they are open to the public. If they want an anonymous account to discuss other topics (I allow these too), they can just open one anywhere. (Yes, I've done more marketing than most, but that's another topic.)

Thanks, Michael

Thank you Dr. Pope as always for your summaries.

............... Apple News includes an article: “The Thing My Therapist Said That Changed My Life—Fifteen Examples” by Amanda Robb.

Here are some excerpts:

We’re all for doing the work, showing up and sitting in that chair (or lying on that well-worn Mies van der Rohe couch) and digging into our psyches to unearth our emotionally healthiest selves.

But sometimes a single statement or question pierces right through your onion layers and serves as a touchstone for the rest of your life.

1. When you don’t know what to do, do nothing

“This has helped me from saying or doing the wrong thing in difficult or emergency circumstances. Simply waiting a beat until I’ve had enough time to think and process a situation allows me to make better choices.” —Tiffany M, 48, New Rochelle, New York

2. You get to choose the type of relationship you have with ____ (fill in the blank)

“My parents divorced when I was about 18. When I was in my early 20s, I found out why. My father is gay. This was nearly 40 years ago, and I didn’t know how to react to my dad and his new partner. I knew I wasn’t comfortable with my siblings’ reactions, but I [still] loved them. And I realized that I loved my dad and I was happy for him. We’re close to this day. It seems like simple advice, but it was a powerful realization for me at the time.” —Kathryn R., 59, Burlingame, California

3. Get outside and walk

“I was a depressed teen, and my therapist told me I had to walk to and from her office from my house, which was 15 to 20 minutes away on foot. On the way there, it allowed me to focus on what I wanted to talk about in the session. On the way back, it helped me process and release what had happened in the session. It was just good for my overall mental health, and I am still exercising for my mental health.” —Victoria V., 53, Bethlehem, Pennsylvania

4. And what was the crime?

“I do a fair amount of Monday-morning quarterbacking, telling myself, I should’ve done this, not that, and then beating myself up. And my therapist would say this in her lovely English accent, and I’d realize there really was no catastrophe.” —Pilar G., 53

5. Just do it tired

“I was in group therapy, and the therapist gave someone else this advice. But it resonated with me because you can come up with a million excuses for not investing in yourself because of where you are. ‘I’m too tired’ is a common one, an easy one. And sometimes you really are exhausted and need to rest. But most of the time, you’re not that wiped out. So just go do whatever it is. Be out there. Be a part of things and see what that brings.” —Sue K., 61, New York City

6. Don’t get on the roller coaster, but always be waiting for them on the platform

“Advice for raising four daughters, including a set of twins. Of course, I did get caught up in their drama sometimes, but remembering this often helped me take a step back from it.” —Kathy I., 60, Charlotte, North Carolina

7. Okay, but at what cost to you?

“This is what my longtime therapist, Ruth, asks when I tell her I’ve taken on too much or I’m tolerating something difficult because it’s easier than confronting someone or admitting that I’m diminishing myself. It instantly re-centers me (I picture myself as that dot in Google Maps) and reminds me that my emotions and energy are worth protecting.” —Jennie T., 52

8. Not my circus, not my monkeys

“My life coach gave me this advice. I was learning to say no to people, but some didn’t accept it! They would give me a whole backstory and reasons I should change my answer to yes. This quote reminds me that I can’t change anyone’s reaction to my responses to things, but I can stick to my responses.” —Karon G., 47, Bayonne, New Jersey

9. With a good book, you’ll never be lonely

“This advice from my therapist after I got divorced resulted in my starting a book-related media company.” —Zibby O., 46, New York City

10. Aren’t you curious about what is around the corner for you?

“I had just experienced a serious traumatic event and was contemplating suicide. I still turn to this thought in dark times.” —Katherine K., 57, Las Vegas

11. You can hold two things at once

“I tend to think about things in categoricals—a career hazard, if you will. We are on time, or we’re late. We are on budget, or we’re not. It’s great for deadlines but bad for feelings. Over the past few years, I’ve had to figure out how to live alongside immense grief, and I remember telling my therapist how guilty I felt about being excited for an upcoming event. ‘You can hold two things at once,’ she said, and it sounds so simple, but it gave me a way to wrap my brain around feeling two diametrically opposed emotions. I can be sad about what isn’t while being excited for what is. It’s useful all the time. Two things can be true, and we can acknowledge both of them.” —Paulie D., 36,

12. Don’t compare your insides to other people’s outsides

“I use this constantly and repeat it to my children. It’s especially useful when I’m with someone who is incredibly intimidating and I’m feeling like a complete loser.” —Lisa C., 64, New York City

13. No one else is going to fight your fight

“My husband had left me. Immediately, I started seeing myself only as a victim. All I felt was self-pity about how badly I’d been betrayed; all I did in therapy was whine and complain. After about six months, my therapist said this to me, and a light bulb went off in my head. If I didn’t stand up for myself, I would be immobilized forever. I would be stuck not being able to trust anyone. Most importantly, I wouldn’t be able to make a new life for myself.” —Mary S., 63, Bozeman, Montana

14. Always follow the advice flight attendants give: Put on your own oxygen mask first, then help others around you

“My brother-in-law is a therapist, and he says this is among the most common advice he gives. I can overextend myself trying to help other people and wind up neglecting to take care of myself and my stuff, which can make me useless all the way around. This helps me keep first things first.” —Jonna A., 52, Reno, Nevada

15. We all have something from our childhood that we had zero control over

“You couldn’t control anyone’s behavior—what they said or how they acted. What you do have control over as an adult is how you allow it to affect the rest of your life, how you act and react to things. This changed my whole way of thinking and allowed me to be in control of my life!” —Brenda S., 59, Nassau, The Bahamas

Ken Pope

Ken Pope, Nayeli Y. Chavez-Dueñas, Hector Y. Adames, Janet L. Sonne, and Beverly A. Greene Speaking the Unspoken: Breaking the Silence, Myths, and Taboos That Hurt Therapists and Patients (APA, 2023)

.................. Merely reposted by: Michael Reeder LCPC Baltimore, MD

#psychology #counseling #socialwork #psychotherapy @[email protected] @[email protected] @[email protected] @[email protected] @[email protected] #psychiatry @[email protected] #mentalhealth #graduatestudents #PsyNP #doctors #nursepractitioners #OMHC

Forwarded from Dr. Ken Pope with small edits to get under size limits.

-------- Forwarded Message -------- Subject: ADHD: Disentangling Genetic, Environmental, & Developmental Risk Factors—New Research Findings

The new issue of the American Journal of Psychiatry includes an article: “ADHD: The Mammoth Task of Disentangling Genetic, Environmental, and Developmental Risk Factors.”

Sarah Kittel-Schneider, M.D., is the author.

Here are some excerpts:

The first medical description of what is currently labeled attention deficit hyperactivity disorder (ADHD) was published as early as the 18th century

....

The underlying causes of ADHD, however, were unclear for nearly 200 years.

Since the beginning of the 21st century, it is largely validated that ADHD is a disorder with a heritability of about 80%, estimated from twin and family studies (4).

....

Polygenic risk scores (PRSs) summarize the risk alleles of an individual and weigh the effect size in an independent GWAS. Using PRSs seems to be useful to capture the synergistic effects of common risk variants of low effect sizes and to identify individuals carrying a higher genetic burden of those common variants (9). Moreover, more rare variants, such as copy number variants (CNVs), are also shown to play a role in ADHD pathogenesis, since there is a significantly increased burden in individuals with ADHD compared with the general population (10).

Not only genetic but also environmental and developmental risk factors and their interaction are suggested to contribute to the onset of ADHD (11). But the investigation of the causality of environmental and developmental risk factors in ADHD is even more complex.

Earlier studies investigating, for example, the impact of smoking during pregnancy on ADHD risk in the exposed child often did not take the mother’s psychopathology or genetic risk into account (12). The same is true for the effect of breastfeeding on ADHD risk (13). Better-designed studies already hinted that the genetic risk of the mother might be the causal factor rather than the harmful effects of smoking in ADHD (14). Only few studies have been published so far looking at pregnant women with ADHD and mother-child interaction in early infancy in mothers (and fathers) with ADHD. Early data hint that women with ADHD are at a greater risk of smoking, drinking alcohol, and using illegal drugs as well as greater risk of pregnancy and birth complications, compared with the general population (15).

Therefore, it is highly challenging to disentangle the genetic from the environmental and developmental risk factors.

For example, preterm birth has been shown to have a relatively consistent association with an increased ADHD risk, but the direction of the effect is less clear (16). Does prematurity lead to ADHD symptoms, or do fetuses with a genetic ADHD risk tend to be born prematurely for unknown biological reasons? Or, as a third possibility, are mothers with ADHD more prone to give birth to premature infants as a result of increased psychosocial stress and unhealthy lifestyle and the causal link is rather the transmission of the genetic risk variants? Finally, is there an interaction or interplay between those different risk factors?

To make it even more complex, several potential environmental risk factors (in pregnancy or after birth) may also share genetic risk with ADHD, such as obesity, gestational diabetes mellitus, autoimmune disorders, allergic disorders, and so on, and there are hints that polygenic liability of ADHD is associated with an increased risk of exposure to environmental ADHD risk factors in individuals without an ADHD diagnosis as well.

A 2019 study by Leppert et al. (17) investigated mothers without a clinical ADHD diagnosis but carrying risk alleles associated with ADHD, compared with mothers without those risk alleles. Of most interest was the fact that the mothers with ADHD risk alleles had increased lifestyle-related negative exposures, such as more mental health issues and pregnancy complications and increased markers of unhealthy nutritional status. However, that study was unable to show a significant association of preterm birth with maternal ADHD genetic risk or with ADHD risk genes in the exposed children.

In this issue of the Journal, Brikell et al. (18) report on a study of the interaction between ADHD PRS, ADHD diagnosis, and environmental risk factors. They studied the association of 24 environmental and developmental risk factors and ADHD polygenic risk scores in a large cohort of 13,697 ADHD case subjects and 21,578 control subjects from a general population sample. There were three times more affected males than females in the sample, which needs to be mentioned, as we estimate that rates of adult ADHD are only 1.5 times higher in men compared with women in population-based studies. Brikell et al. included birth-related, somatic, and psychosocial risk factors, including parental mental disorder diagnoses, to evaluate potential gene-environment interactions. Not surprisingly, they could confirm a significant association of ADHD PRS with ADHD diagnosis. The higher the PRS burden, the greater the ADHD risk, which is confirmed in other studies (19). It is most interesting that in the general population sample, the authors could show a significant association of ADHD PRS with half of the 24 environmental risk factors. Small for gestational age, maternal autoimmune disorder, having had at least one infection, having had five or more infections, and a history of mild traumatic brain injury (TBI) were significantly associated. Furthermore, ADHD PRS was significantly associated with most of the psychosocial risk factors, such as income in the lowest quintile, low education level, living in a single-parent household during the first 5 years of life, being under age 20 at birth of index child, and parental history of mental disorder. Nineteen of the 24 risk factors were associated with a diagnosis of ADHD. The most significant associations were reported for low birth weight, epilepsy, and low parental education. Adjusting for ADHD PRS load and parental mental disorder diagnosis did not largely change the findings.

Surprisingly, Brikell et al. only found a tendency of gene-environment interaction between ADHD PRS and four of the 24 risk factors, namely, maternal autoimmune disease, TBI, paternal unemployment, and lower paternal age at birth of index child.

This suggests that individuals who are burdened with a higher ADHD PRS load and are additionally exposed to one of these four environmental risk factors might have a higher probability of developing ADHD.

The only gene-environment interaction that survived false discovery rate correction for multiple comparison, however, was the interaction of maternal autoimmune disease and high ADHD PRS load.

The results from the Brikell et al. study are very promising and point out the importance of what data should be included in future studies on the etiopathology of ADHD.

They strengthen the evidence of the heterogeneity of ADHD disease mechanisms and point toward the possibility of disentangling genetic and environmental risk factors as well as studying their complex interplay and interactions.

Recent studies give first hints as to how environmental factors can influence gene expression by changes in the epigenome, but this field is only in its infancy (20). More insight into ADHD pathomechanisms will reveal targetable risk factors that then can be addressed by interventions, and the causality will finally be proven in future interventional studies.

REPRINTS & OTHER CORRESPONDENCE: [email protected].

Ken Pope

Thank you Dr. Pope.

Merely forwarded by:
Michael Reeder LCPC
Baltimore, MD
https://www.hygeiacounseling.com
https://lem.clinicians-exchange.org
https://mastodon.clinicians-exchange.org
https://www.clinicians-exchange.org

Another Psychology Today article from one of our email listserv members!

TITLE: New PT Piece - The Mystery of Narcissism :) https://www.psychologytoday.com/us/blog/the-intelligent-divorce/202301/the-mystery-of-narcissism

Hi all, This is a new PT piece that may help a client or two. It is part of a series that I've been thinking about. Mark Banschick, MD – Stamford, CT

The Mystery of Narcissism https://www.psychologytoday.com/us/blog/the-intelligent-divorce/202301/the-mystery-of-narcissism

Mark Banschick M.D. on January 23, 2023 The origin of narcissistic personality disorder (or associated traits) is a great mystery to solve.

#psychology #psychotherapy #psychiatry #personalitydisorders #socialwork #psychologytoday #narcissist #narcissism @[email protected] @[email protected] @[email protected] #mentalhealth @[email protected]

TITLE: SPEAKING THE UNSPOKEN by Ken Pope, Nayeli Chavez-Dueñas, Hector Adames, Janet Sonne, & Beverly Greene

From Ken Pope:

I am (extremely, exceptionally, over-the-top) happy to announce that APA will publish a special book later this year: Speaking the Unspoken: Breaking the Silence, Myths, and Taboos That Hurt Therapists and Patients.

The book was a creative collaboration of 5 co-authors: Kenneth S. Pope, Nayeli Y. Chavez-Dueñas, Hector Y. Adames, Janet L. Sonne, and Beverly Greene.

Speaking the Unspoken The Kindle and paperback versions can now be pre-ordered from APA, Amazon, Barnes & Noble, Bookshop.org, eCAMPUS.com, and the other usual suspects.

Below are reviews, followed by the Table of Contents.

“Here, at last, is the book we never really knew we needed, but needed so desperately. ‘Silence and silencing have shaped the psychotherapy profession.’ Truer words were never (un)spoken.”

—Eric Y. Drogin, JD, PhD, ABPP
Harvard Medical School
Former Chair, APA Committee on Professional Practice and Standards

“This book is essential reading for anyone who practices, teaches, supervises, and studies psychotherapy. It will help you to recognize and overcome barriers to thinking clearly, speaking openly, and listening respectfully about unspoken topics in our profession. The engaging vignettes, thought-provoking exercises, suggested strategies, and informational pearls of wisdom will strengthen your courage, humility, readiness, and skills to engage in authentic discussions.”

—Joan Cook, PhD
Professor of Psychology
Yale University

“Kenneth S. Pope, the foremost psychological ethicist of our time (someone who walks the talk), and a diverse and distinguished cadre of co-authors provide a necessary exploration of censored and challenging topics in psychotherapy. They show how correct Sigmund Freud was in positing that suppressed material will ‘come forth later in uglier ways’.”

—Etzel Cardeña, PhD
Thorsen Professor in Psychology
Lund University, Sweden
Co-editor of Varieties of Anomalous Experience and
founding editor of the Journal of Anomalous Experience and Cognition

“What a treasure of a book! The teaching, practice, and profession of psychotherapy are enhanced when we openly and directly address, understand, and continuously process ‘taboo’ topics that are challenging. The amazing authors provide history and sources of resistance to topics such as group identity, anger, oppression, and sexual feelings regarding clients. Most importantly, and of significant value, the book provides strategies that inspire us to have the courage, confidence, and determination to address the relevant issues in the various contexts in which we work. After reading this outstanding, compelling, must-read contribution, you will agree that creating a culture of speaking up benefits us all!”

—Melba J. T. Vasquez, PhD, ABPP 
Independent Practice
Former President, American Psychological Association

“Speaking the Unspoken: Breaking the Silence, Myths and Taboos that Hurt Therapists and Patients is a must-read for EVERY therapist. The authors raise awareness and brilliantly illustrate how to address critical, contemporary, and challenging issues in therapy and supervision, including oppression and racism. I highly recommend this book!”

—Lillian Comas-Díaz, PhD 
Recipient of the American Psychological Association Gold Medal Award for Life Achievement in the Practice of Psychology
Past President, Psychologists in Independent Practice, APA Division 42
Author: Multicultural Care: A Clinician’s Guide to Cultural Competence

“Have you ever avoided talking about something important? Have you ever wished for the courage to speak up? In clear and accessible prose, Speaking the Unspoken explains what underlies the fear and the other obstacles that keep us silent. With remarkable clarity, the book models the courage to discuss complex topics and provides practical advice for how and when to discuss previously unspoken matters. Every psychotherapist should read this intelligent and transformative book.”

—Jennifer Joy Freyd, PhD
Founder and President, Center for Institutional Courage
Professor Emerit, Psychology, University of Oregon
Adjunct Professor, Psychiatry & Behavioral Sciences, Stanford University
Editor, Journal of Trauma & Dissociation

“Brave and compelling, Pope and colleagues’ volume paves the way to change and enlightenment of mindsets in clinical training, supervision, and practice. This courageous book outlines what is NOT DISCUSSED in clinical practice, supervision, and consultation, the impacts of these, and guideposts to identify, reflect, and address them. The authors address emotionally, politically, and personally charged topics that are avoided. It is a “must-read” for educators, supervisors, and clinicians-in-training.”

—Carol Falender, PhD
Adjunct Professor, Graduate School of Education and Psychology, Pepperdine University
Clinical Professor, University of California, Los Angeles, Psychology Department
Co-author, co-editor of six books on Competency-based Clinical Supervision, one on Competency-based Consultation

“‘Several topics have been historically avoided in psychotherapy.’ The opening line in this book sheds light on a central truth – we tend to avoid certain topics because we have been told it is ‘uncultured’ to address them in ‘polite society.’ Although we may wish it to be so, averting our gaze does not remove these issues and problems from reality—not in society and not in our practices. The authors, experts in ethics, multiculturalism, practice, and training, excellently guide us through our own necessary edification. They invite us not to collude with the silence and the avoidance created when we hide behind the veil of ‘politeness’ and the guise of clinical neutrality. The book aims to enhance our skills and tolerance to feeling distressed and uncomfortable when we do “Break the Silence.” In learning how to do the necessary yet uncomfortable, we benefit our profession and the people we serve.

—Cynthia de las Fuentes, PhD
Independent Practice

Here’s the Table of Contents:

Dedication Acknowledgments

Introduction: Unspoken Topics in Psychotherapy and How This Book Can Help Break the Silence

Part I: The Problem of the Unspoken

A Chilling Context for Psychotherapy: Cancel Culture, Hyperpolarization, Books and Topics Banned by the State, Frightened Academics, and Self-Censorship
A Silenced Profession: The Toxic Effects of Taboo Topics
Systems of Silencing and Cognitive Cues for Keeping Quiet
An Example of the Problem: Therapists' Sexual Attractions, Arousals, and Fantasies

Part II: Preparing to Break the Silence

Looking Inward: A Self-Assessment of How We Respond to Challenging Topics
Strengthening the Courage to Speak Up: Creating a Supportive Context

Part III: Speaking the Unspoken—Exercises for Explorating and Learning

Talking About Physical Difference and Disability
Talking About Sexual and Affectional Orientation
Talking About Sexual Reactions to Clients
Talking About Anger
Talking About Oppression
Speaking Up About White Supremacy Culture
Talking About Religion
Talking About Money and Fees
Talking About Death and Dying

Part IV: Speaking the Unspoken Beyond Psychotherapy

Speaking Up in Supervision and Consultation
Speaking Up in the Profession and the Community

Part V: But What If...

Hitting a Wall, or The Wall Hitting Us: What to Do When Confused, Scared, Disheartened, or Stuck

References About the Authors Index

I would greatly appreciate your passing the word to any lists or individuals who might be interested in this book.

Ken Pope

#psychology #psychiatry #socialwork #mentalhealth @[email protected] @[email protected] @[email protected] @[email protected] #supervision #taboos #psychotherapy

TITLE: HIGHLY RECOMMENDED: JUDY HERMAN: TRUTH & REPAIR

I’m writing to recommend a remarkable new book, Truth and Repair: How Trauma Survivors Envision Justice (Basic Books—Hardcover, Kindle, eBook, Audio CD, Audible.com Audiobook), by a giant in our field, Dr. Judith Herman.

Here’s a brief bio:

Judith L. Herman M.D. is a Professor of Psychiatry at Harvard Medical School, and co-founder of the Victims of Violence Program at The Cambridge Hospital, MA. She is the author of two award-winning books: Father-Daughter Incest (Harvard University Press, 1981) and Trauma and Recovery (Basic Books, 1992) which have been translated into numerous languages and reprinted editions. Considered one of the world's leading experts in the field of psychological trauma, Herman has lectured widely on the subject of sexual and domestic violence. She has received numerous awards including: a Guggenheim Fellowship in 1984, the 1996 Lifetime Achievement Award from the International Society for Traumatic Stress Studies, and the 2000 Woman in Science Award from the American Medical Women's Association. In 2007 she was named a Distinguished Life Fellow of the American Psychiatric Association.

The reviews have been stunning. Here’s a small sampling:

“Herman has written some of the most seminal, life-changing books on violence against women. Here in her new book, Truth and Repair, she does something even more radical. She listens to the survivors themselves and skillfully shapes their voices and wisdom into a practical and truly enlightened road map for our future. Every word rang true and essential.” ―V (formerly Eve Ensler), playwright of The Vagina Monologues

“For thirty years, every single book written about the impact of trauma has stood on the shoulders of Herman’s groundbreaking book Trauma and Recovery. Now, thirty years later, we receive a bookend to that masterpiece, examining how survivors of gender-based violence seek justice and healing. Truth and Repair is a deeply researched and thought-provoking book offering hope and healing for victims of violence, many of whom have felt betrayed, ignored, or retraumatized by existing larger societal institutions.” ―Michelle Bowdler, author of Is Rape a Crime?

“Herman’s earlier studies of abuse of women and children recast our understanding of trauma. Now, in Truth and Repair, she comes full circle in describing how initially powerless victims can, through innovative social arrangements, achieve hard-won survivor justice. In the process, we learn much about what justice really means for traumatized people. Herman’s perspective is deeply humane and grounded in historical and political reality. Her work stands alone in its arc and originality.” ―Robert Jay Lifton, MD, Columbia University

“Three decades after the publication of her foundational Trauma and Recovery, Herman brilliantly confronts us with another vital, but much ignored, aspect of recovery: social justice. Justice is an essential component for healing the godforsaken sense of humiliation and abandonment so central in traumatizing experiences. When justice is denied, trauma’s imprint is likely to fester in the form of helpless rage. A magnificent and inspiring contribution with profound implications for the healing professions and for society at large.” ―Bessel van der Kolk, MD, author of the #1 New York Times bestseller The Body Keeps the Score

“This book is a revelation. With careful precision and dogged research, Judith Herman offers us not only a diagnosis of our most pressing social ailments, but a prescription for healing. Rarely does a book offer this level of insight, hope and remedy.” ―Rachel Louise Snyder, author of No Visible Bruises

“Through masterful storytelling, Judith Herman charts the course from trauma to justice and compels us to follow it. An inspiring and practical call to action, Truth and Repair celebrates survivors’ wisdom and their power to heal themselves and the world we live in.”
―Anita Hill

The book can be pre-ordered (it’ll be out March 14) from Basic Books, Amazon, Barnes & Noble, Google Play, etc.

PLEASE NOTE: IF YOU ORDER TODAY THROUGH JANUARY 27 AT BN.COM, YOU CAN GET 25% OFF WITH CODE PREORDER25!

It would be great if everyone would pass the word about this new contribution to any lists or individuals who might be interested. Thanks!

Ken Pope

#psychology #socialwork #psychotherapy #psychiatry #trauma @[email protected] @[email protected] @[email protected] @[email protected] #mentalhealth #bookreviews

TITLE: Video on Autism and Women

Absolutely brilliant video on female pattern Autism. Any individual can have aspects of either the stereotyped "male" pattern, "female" pattern, or both:

https://vimeo.com/122940958

Book: Aspergirls https://smile.amazon.com/Aspergirls-Empowering-Females-Asperger-Syndrome/dp/1849058261/

-- Michael

#autism #femaleautism #aspergirls #psychology #socialwork #psychiatry #mentalhealth #psychotherapy @[email protected] @[email protected] @[email protected] @[email protected] #aspergers

I've heard counselor, psychotherapist, mental health professional, and of course the infamous "provider" (thank you insurance companies).

Now I am a "supplier" -- thank you to another insurance company for feeding my ego today. Not.

As another therapist said on a related conversation -- the less prestigious and individual we sound, the more replaceable we are, the less we can be paid. They went on to speculate that soon we will be called titles that imply we are a financial burden by existing.

Michael Reeder LCPC Baltimore, MD

#psychology #psychiatry #mentalhealth #socialwork #healthpay @[email protected] @[email protected] @[email protected] @[email protected] #psychotherapy

TITLE: The Frightening Truth About Youth Suicidality and Fentanyl: Our Kids are Not Ok - My New Psychology Today Article

Our kids are not even close to being OK. I’m astonished at how many patients I’m currently treating that have been directly or indirectly impacted by suicide or fentanyl poisoning... There’s a new crop of youth who are suffering with anxiety, depression, and posttraumatic stress disorder (PTSD) because of the residual effects of these tragedies. To read more:

https://www.psychologytoday.com/intl/blog/being-your-best-self/202303/the-frightening-truth-about-youth-suicidality-and-fentanyl

Please share with others who may be interested or who may benefit.

Warmly,

Michelle Michelle Maidenberg, Ph.D., MPH, LCSW-R, CGP ////

W E B / I N S T A G R A M / F A C E B O O K / T W I T T E R / L I N K E D I N

TED TALK: Circumventing Emotional Avoidance

My new book Ace Your Life: Unleash Your Best Self and Live the Life You Want is available to order at: Thriftbooks, Barnes and Noble, Walmart, Target and Amazon. Note that all paperbacks come with a free ebook.

#psychology #counseling #socialwork #psychotherapy #research @[email protected] @[email protected] @[email protected] @[email protected] #suicide #mentalhealth #Fentanyl #kids #teens

TITLE: Online Pill Identifier: Search by Imprint, Shape, or Color (With Plenty of Data Tracking)

Thank you Dr. Pope for initial message below.

This is really cool.

It should also be noted that when you use it, the drugs.com server communicates with -- and sends something about you -- to:

securepubads.g.doubleclick.net stats.g.doubleclick.net www.google-analytics.com analytics.google.com fundingchoicesmessages.google.com www.googletagmanager.com fonts.gstatic.com www.gstatic.com ads.rubiconproject.com sb.scorecardresearch.com

Don't pretend for a moment that what medications you are taking are likely to remain private.

So load-up Ghostery and Privacy Badger into your web browser and hope for the best.

-------- Forwarded Message --------

Drugs.com provides an online pill identifier service.

Here’s the announcement: Pill Identifier Search by imprint, shape or color Use the pill finder to identify medications by visual appearance or medicine name. All fields are optional.

Tip: Search for the imprint first, then refine by color and/or shape if you have too many results.

Here’s the link: https://www.drugs.com/imprints.php

PLEASE NOTE: The Drugs.com site also provides an interactions checker and other services.

Ken Pope

Merely forwarded by:
Michael Reeder LCPC
Baltimore, MD


 #psychology #neurology #socialwork #psychiatry @[email protected] @[email protected] @[email protected] #mentalhealth #psychotherapists @[email protected] #pharmacy #medicationchecker #drugs #druginteractions #cookies #tracking #hacking #3rdpartytrackers #HIPAA #privacy #dataprivacy #webbeacons

TITLE: Declining Psychotherapy Reimbursement in Inflation-Adjusted Dollars & the Inability of Psychotherapists to Collectively Bargain or Really Have Any Power at All in Their Reimbursement

(Posted for anonymous author by Michael Reeder LCPC -- I did not write it myself but wish I did :) )

My Medicare reimbursement for 45 minutes of psychotherapy in 1990 was $86.82 (in my region -- I have billing records back to 1985, but Medicare did not contract with psychologists until 1990). Currently it is $91.38 (Santa Barbara County), but minus 2% sequestration, it is actually $89.55.

You can find your region's version by searching 2023 Medicare Physician Fee Schedule (using the name of your state -- and also searching reimbursement rates by year). 

Using the US Bureau of Labor Statistic's inflation calculator

https://www.bls.gov/data/inflation_calculator.htm

which BTW is the most conservative with regard to inflation.

$86.82 in 1990 had the same buying power as $204.05 today. $89.55 divided by $204.05 equals 44% -- i.e., a pay cut of 56%.

In year 2000, in my region Medicare paid $95.89 for 45 minutes of psychotherapy (then coded 90806, now coded 90834). 

Using the CPI inflation calculator, $95.89 in year 2000 had the same buying power as $169.89 today. In my region, Medicare currently pays $105.02 for 90834 -- but reduced 2% for sequestration, actually pays $102.92. $102.92 divided by $169.89 = 61%, so only a 39% pay cut. That also tells us that reimbursement dropped 17% between 1990 and year 2000.

The biggest impediment to negotiating with insurers is a legal precedent from the late 1970's that prohibits psychotherapists from engaging in collective bargaining. Theoretically under the Sherman Act of 1890, we might form 'trusts' to set fees and control the market.

As absurd as this sounds, it has become even more absurd since the advent of managed health care in the 1980's and our ability to participate as Medicare providers in 1990. 

Insurers create contracts in which they unilaterally set reimbursement rates, documentation requirements and other working conditions. Although we are all given the same contract, and are thus treated as a class of workers, we are legally prohibited from negotiating contracts as a group of workers.

Last week, I wrote (again) to APA's legal team, asking them to prioritize this issue. Historically, professional associations beg off, arguing that they lack the resources to take on trillion dollar a year private insurance corporations, much less the federal government.

Please let your professional associations know that the right to collective bargaining is a crucial issue, and in the context of reimbursement that is less than half what it was in 1990, perhaps the criterion issue for the survival of our profession.
#psychology #counseling #socialwork #psychotherapy @[email protected] @[email protected] @[email protected] @[email protected] #union #unionizing #pay #healthcare #reimbursement #ShermanAct #APA #ACA #NCSW #inflation #wages

Please suggest ideas for additional communities here. It's also theoretically possible --as we grow -- for members to moderate their own communities of interest.