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THERAPY and PSYCHOLOGICAL TESTING
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Copyright 2008 Patricia A. Farrell, Ph.D.
Therapy comes in just a few forms. Primarily, therapies change the way you approach life, or help you learn to control physical reactions. What type of therapy will be most beneficial for your problem and who is most qualified to provide it are two of the most important questions you will ask in your quest for help. Always remember one thing, however, and that is that you are a consumer of a service, not a supplicant before a higher power.
Remember, too, that no one can offer a guarantee of results and not everyone is sufficiently trained or has the experience for every problem. As there is in much of medicine, there is specialization, licensing and on-going training. Never be afraid to question, never feel that you don't have a right to understand or that any concept is beyond your ability to understand. The good teacher and the good therapist have this one thing in common; they make the complex simple to understand.
Do your research, ask questions and seek the answers you need. Remember, too, that therapy doesn't always mean either "talk" therapy or medication. Many times, it may be a combination of the two.
One more thing to remember is needed here. I've reviewed mental health providers' websites and I find that they offer a "menu" of therapeutic interventions including everything from vocational issues to criminal court evaluations. The piece that is missing is how they received training in these modalities. Taking a seminar or a course does not prepare someone to do child custody cases nor does it insure adequate forensic evaluations. True, some courts may accept these individuals as qualified, but, unfortunately, the court personnel may not have the requisite knowledge to evaluate the credentials of the individual and not all states have a strict set of standards for practitioners in these areas. Therefore, it becomes even more important that, whenever considering a specific service, you look for true certification or a state-approved and licensing-board mandated background. This is not a restaurant where the menu provides some assurance of the skill of the chefs. We're dealing with lives and a cavalier attitude or a fudged resume for the purposes of self-aggrandizement is totally unacceptable and, probably, actionable. You might look into local licensing board rules and regulations for actions against such persons.
PROFESSIONAL ETIQUETTE
There seems to be a change in office practices within the medical community and, in my opinion, it sets up a situation which is not in favor of the patient and there's a question that a patient's rights are not being respected. I refer to the all-too-often practice of calling patients by their first names.
I've sat in crowded waiting rooms and watched as a nurse came to the door and summoned an elderly man or woman into the examining rooms by calling out, "Mary, you can come in now." How wonderful that "Mary" can come in now. Doesn't she deserve the same degree of professional respect that is accorded to the MDs or other professionals who care for her? Does she have the right to begin immediately saying to her MD, "You know, Jim, I've got this pain..." Would Jim blanch at the thought that she'd have the gall to call him by his first name? You bet he would and so would a lot of other medical professionals. The relationship set up by calling a patient by their first name is what we know as "one up, one down" and it's an uneven playing field from the start.
Patients are purchasing a service, not asking for a favor, not engaging in a social relationship or anything near it. They are to be accorded the respect they deserve and nothing less. When I taught medical students, the first thing I told my students when we came to a hospital ward, was to introduce themselves and ask the patient how they preferred to be addressed; Mr., Mrs. or their first name. It is the patient's discretion here, not the professional's, that should be considered as the determining factor in this relationship. Nothing less is acceptable.
The Truth About Mental Health Disorders (video)
This video is not intended to influence you in any way. I am presenting it in the spirit of debate and information, not indicating by its presence here that I totally endorse it or totally disagree with it. You make the judgment.
Psychology vs. Psychiatry (video)
There's a lot of confusion on the part of consumers on this point, so here's a psychology professor explaining, in his view, the basic differences.
WHO'S TESTING YOU AND YOUR KIDS?
Increasingly, psychological testing, not psychiatric testing, is becoming the norm for school evaluations and job placements, military service, forensic settings and for kids and adults with attentional problems and developmental disabilities. My question is: Who's doing the testing and are they truly qualified to do this? What should you know about their academic preparation and the supervision they received in this testing? The question isn't one of the degree that they indicate they hold (Ph.D., Ed.D, Psy.D., MSW, M.A.) or their licensing credentials (licensed psychologist, LPC, LMHC or LCSW, APN), but how they came to be "expert" enough to insure quality evaluations by adequately prepared individuals. Does a weekend seminar suffice for testing expertise? Who certifies that they are qualified; they do themselves, any licensing authority, test for establishing expertise? These are not questions to be dismissed or for anyone to be dismissive of them. They are at the heart of the question regarding a need for services and which services will best provide what that individual needs. Too many people seem to be holding themselves out as experts and too many others are willing to accept their word regarding this expertise or a piece of paper that purports to attest to their expertise. To acquaint you with some of the guidelines regarding psychological testing, I've provided a few links that will fill in the blanks for you.
American Psychological Association Testing and Assessment
Rights and Responsibilities of Test Takers
The report of the Task Force on Test User Qualifications (pdf)
Code of Fair Testing Practices in Education (pdf)
National Council on Measurement in Education
Code of Fair Testing in Education
Guidelines for Psychological Evaluations in Child Protection Matters
CHILD
ABUSE REPORTING STANDARDS
Child abuse and/or neglect is never condoned and children are to be protected, not only in the presence of proof-positive, but when there is a suspicion of abuse or neglect and the list of those who are mandated to report is long; just about everyone in a position of trust. Those who report are not subject to lawsuit unless it can be proven that the reporting was done, in my understanding, in a malicious, baseless manner to further some personal agenda. The reporting is not sufficient when the individual who is mandated to report has not notified the correct agency. So, a teacher telling the principal or a therapist telling their supervisor or clinic manager is not sufficient to satisfy the letter of the law in these instances. See the California link below for more information on this.
NASW Standards for the Practice of Social Work with Adolescents
Council on Accreditation (Canadian Standards)
Child Abuse and Neglect Reporting
Addressing Child Abuse in Japan
Standards for Child Welfare Practice in California
The World Medical Association on Child Abuse and Neglect
MMSD Reporting Child Abuse & Neglect (school policy)
APA Guide on Child Abuse and Neglect in Graduate and Professional Education and Training
Child Abuse Protocol Development Guide (tribal guides)
Options and Dilemmas Facing British Mental Health Social Work
How to Be a Mental Health Legal Guardian
American Mental Health Counselors Association Code of Ethics
Texas Attorney General: When You Suspect Child Abuse or Neglect
Teachers: What Should You Do When You Suspect Child Abuse?
Pennsylvania: Child Abuse and Protective Services
Michican Education Association: Duty to Report Child Abuse
New York City: Mandated Reporters
Vanderbilt Medical Center: Immunity Granted for Reporting Child Abuse
Law & Psychiatry: Child Abuse Reporting Laws
Adelphi University: Reporting Mandates
The Real Story of Schizophrenia (video)
THERAPY
Controlling
Anger Before It Controls You
The End of Peer Review and Traditional Publishing as We Know It
Medscape Drug Reference Results for Anxiety
Alfred Adler Institutes (selected publications)
Spanish for Mental Health Professionals (book)
Sigmund Freud and the Freud Archives
Aaron Beck (with Charlie Rose, video)
Martin Seligman (Authentic Happiness)
American Psychological Association Help Center
American Psychiatric Association Practice Guidelines
American Association on Intellectual and Dev. Disabilities
Schizophrenia Association of Great Britain
Asperger's Association of New England
National Alliance on Mental Illness (NAMI)
National Institute of Mental Health (NIMH)
National Association of Social Workers
American Academy of Nurse Practitioners
American Academy of Family Physicians
American Academy of Child & Adolescent Psychiatry
Association for Applied Psychophysiology & Biofeedback
The Beck Institute for Cognitive Therapy and Research
Payne Whitney Psychiatric Clinic
Barnes Jewish Hospital of St. Louis
Psychiatric Hospitals and Medical Centers
Veterans Administration Hospitals by State
California
Board of Psychology re Sex with patients
APA booklet on What Makes Kids Care
Interventions for animal hoarding
Canadian Veterans and war stress
GAO report on military dependants
In case your child is a victim
National pediatricians on discipline
Safeguarding your students against suicide
Can you be involuntarily committed to a psychiatric hospital or ward for almost no cause? Probably not, but it is a good idea to acquaint yourself with the various state laws that govern commitment and with the writings of those who tackle this often-difficult subject.
Psychiatric Rights (Rites?) - book by Dr. Thomas Szasz
Unjustified Psychiatric Commitment
Outpatient Psychiatric Commitment
Psychiatric Commitment and Involuntary Hospitalization
Religion & Ethics: Involuntary Commitment
VT Supreme Court Overturns an Involuntary Commitment
Involuntary Commitment/Treatment
Position Statement on Involuntary Commitment
The Challenges of Involuntary Commitment
I, Driven, Memoir of a Teen's Involuntary Commitment
Involuntary Commitment by Relatives
Mental Health Legal Issues: Involuntary Commitment, False Arrest and Imprisonment
The National Mental Health Consumers' Self-Help Clearing House
NY Moves Toward Involuntary Residential Commitment
Public Policy Platform on Involuntary Commitment
Law Gives California Counties Commitment Authority
Utah Involuntary Commitment Laws
State Involuntary Commitment Laws
Wisconsin Court Rejects Attempt to Narrow Commitment Law
Missouri Mental Health Commitment
Illinois is Considering Broadening Its Commitment Law
What is HIPAA and why should you be concerned about it? It stands for "Health Information Portability and Accountability Act" and, in essence, it provides you with wide-ranging protection of your medical information. So, for instance, if you enter a medical office and are asked to sign in, the sign-in sheet should not be accessible to everyone so that can easily see who's there. Suppose you were in an office that dealt with particularly delicate medical problems, would you want anyone coming in to know you were receiving that service? Even if you don't have a concern now, could someone use this information in the future? It also requires that you receive a printout of a statement of the office's practices regarding the protection of medical records. Although you are required to receive this on your first visit, often you will be told that there's a copy in a folder or on the wall or "we can't find it now." Not acceptable. You are entitled to your own copy which you can take with you. If you'd like an overview, go to the HHS link.
How
to File a Complaint (text document)
Protecting the Privacy of Patient Information
What you need to know about research institutions
Colorado Task Force on Information Technology
Public Health Dispatch (Disease Reporting)
Communication and Records (APA)
Office for Civil Rights - HIPAA (US Gov.t)
Centers for Medicare and Medicaid (US Gov.t)
National Council for Prescription Drug Programs
Patient Privacy Compliance Guide
Patient's Right to Sue (NY Times article)
Foundation for Taxpayer and Consumer Rights
Forensic Psychiatry and Medicine
A patient's right to sue - Policy & Practice
Negotiating the patient's right to sue
Georgia Watch - Time to Right a Wrong
The People vs HMOs (Time magazine)
False Memory Syndrome and Therapist Liability
If you wish to see if a licensed professional in your state, or any other state, has been disciplined, placed on suspension of license, fined, had their license pulled or were placed under supervision, the state boards of licensing publish lists of those disciplined on their websites each month. Go to the state site, look for the specialty and read the public notices or minutes of meetings. Some states, such as California, will send you monthly notices of these actions if you sign up for this free service. You can use these links to insure that a professional does have a license in your state.
Canadian Psychology Laws and Licensing Boards
American Medical Association state listings
American Association for Marriage & Family Therapy (LMFT)
International Association of Marital and Family Counselors
State Professional Licensing Boards
American Counseling Association
US Physician Disciplined for Criminal Activities
Physicians Disciplined for Sex-Related Offenses
Disciplinary Action by Medical Boards and Prior Behavior in Medical School
Research and Compare Physicians
ECT (shock therapy) USE FOR CHILDREN
A good deal of discussion is currently going on within the psychiatric, medical and psychological communities as well as parent and mental health groups and it's all on psychotropic use in children. Little note seems to have been made about ECT (electroconvulsive shock therapy) for children. The links here present only a limited perspective on this issue, granted, but it can provoke a dialog that is surely needed when it comes to care of children with any psychiatric disorder.
The Use of ECT in Special Populations
Electro convulsive therapy in a pre-pubertal child with severe depression
NY Assembly Report on ECT - Special Populations
Tratamiento electroconvulsivo en niņos y adolescentes
Mental Health Blogs Related to Meds, Therapy, Etc.
Who is writing within the mental health community and what are they saying? Consumers need to become aware of these discussions since they can bring to the fore topics which have been little-discussed or which are causing waves.
The Carlat Psychiatry Blog (recommended)
Shrink Rap (by psychiatrists for psychiatrists)
Clinical Psychology and Psychiatry: A Closer Look
Hooked: Ethics, Medicine and Pharma
Wall Street Journal Health Blog