All posts by johnsommersflanagan

Clinical Interviewing, Suicide Assessment and Intervention

Three Strategies for Conducting State-of-the-Art Suicide Assessment Interviews

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Tomorrow is the first day of the MUS Statewide Summit on Suicide Prevention in Bozeman, Montana. From 2:30-3:45pm I’ll be participating on a panel: “Screening and Intervention Options with the Imminently Suicidal.” During my 10-12 minutes, I’ll be offering my version of what I view as essential strategies and skills for face-to-face suicide assessment interviewing. Below is the handout for the Summit. I think it’s a great thing that we’re meeting in an effort to address this important problem in Montana. Thanks to Lynne Weltzien of UM-Western in Dillon and Mike Frost of UM-Missoula for the invitation. Here’s the handout . . .

Three Strategies for Conducting
State-of-the-Art Suicide Assessment Interviews
John Sommers-Flanagan, Ph.D.
University of Montana

I. To conduct efficient and valid suicide assessment interviews, clinicians need to hold an attitude of acceptance (not judgment) and use several state-of-the-art assessment strategies.

II. If clinicians believe suicide ideation is a sign of psychopathology or deviance, students or clients will sense this and be less open.

III. Asking directly about suicide is essential, but experienced clinicians use more nuanced assessment strategies.

a. Normalizing statements

  • I’ve read that up to 50% of teenagers have thought about suicide. Is that true for you?
  • When people are depressed or feeling miserable, it’s not unusual to have thoughts of suicide pass through their mind. Have you had any thoughts of suicide?

b. Gentle assumption (Shea, 2002, 2004, 2015)

  • When was the last time you had thoughts about suicide?

c. A solution-focused mood evaluation with a suicide floor

1. “Is it okay if I ask some questions about your mood?” (This is an invitation for collaboration; clients can say “no,” but rarely do.)

2. “Please rate your mood right now, using a zero to 10 scale. Zero is the worst mood possible. In fact, zero would mean you’re totally depressed and so you’re just going to kill yourself. At the top, 10 is your best possible mood. A 10 would mean you’re as happy as you could possibly be. Maybe you would be dancing or singing or doing whatever you do when you’re extremely happy. Using that zero to 10 scale, what rating would you give your mood right now?” (Each end of the scale must be anchored for mutual understanding.)

3. “What’s happening now that makes you give your mood that rating?” (This links the mood rating to the external situation.)

4. “What’s the worst or lowest mood rating you’ve ever had?” (This informs the interviewer about the lowest lows.)

5. “What was happening back then to make you feel so down?” (This links the lowest rating to the external situation and may lead to discussing previous attempts.)

6. “For you, what would be a normal mood rating on a normal day?” (Clients define their normal.)

7. “Now tell me, what’s the best mood rating you think you’ve ever had?” (The process ends with a positive mood rating.)

8. “What was happening that helped you have such a high mood rating?” (The positive rating is linked to an external situation.)

This protocol assumes cooperation. More advanced interviewing procedures can be added if clients are resistant. The goal is a deeper understanding of life events linked to negative moods and suicide ideation and a possible direct transition to counseling or safety planning.

 

IV. When students or clients disclose suicide ideation clinicians should:

a. Stay calm

b. Express empathy

c. Normalize ideation

d. Move to conducting a full suicide assessment interview (i.e., R-I-P-SC-I-P*) or refer the student/client to someone who will do a full assessment along with safety planning

e. Use suicide interventions as appropriate

 

V. Using Shneidman’s “Alternatives to Suicide” approach is a parsimonious way to simultaneously assess and intervene to reduce danger to self

 

VI. IMHO: All health and mental health providers should be trained to use these clinical skills and strategies when working with potentially suicidal students/clients.

 

Adapted from: Clinical Interviewing (6th ed., 2016), Wiley. Feel free to share this handout as long as authorship is included. For more information or to ask about professional workshops for your organization, contact John Sommers-Flanagan: john.sf@mso.umt.edu or 406-721-6367.

 

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Clinical Interviewing, Counseling and Psychotherapy Theory and Practice, Personal Reflections

Parallel Process in Clinical Supervision

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This short case example from the forthcoming 6th edition of Clinical Interviewing is a small tribute to all the great supervisors I had over the years.

Case Example 7.2:

Intermittent Unconditional Positive Regard and Parallel Process

Abby is a 26-year-old graduate student. She identifies as a White Heterosexual female. After an initial clinical interview with Jorge, a 35-year-old who identifies as a male heterosexual Latino, she meets with her supervisor. During the meeting she expresses frustration about her judgmental feelings toward Jorge. She tells her supervisor that Jorge sees everyone as against him. He’s extremely angry at his ex-wife and he’s returning to college following his divorce and believes his poor grades are due to racial discrimination. Abby tells her supervisor that she just doesn’t get Jorge. She thinks she should refer him instead of having a second session.

Abby’s supervisor listens empathically and is accepting of Abby’s concerns and frustrations. The supervisor shares a brief story of a case where she had difficulty experiencing positive regard toward a client who had a disability. Then, she asks Abby to put herself in Jorge’s shoes and imagine what it would be like to return to college as a 35-year-old Latino man. She has Abby imagine what might be “under” Jorge’s palpable anger toward his ex-wife. The supervisor also tells Abby, “When you have a client who views everyone as against him, it’s all the more important for you to make an authentic effort to be with him.” At the end of supervision Abby agrees to meet with Jorge for a second session and to try to explore and understand his perspectives on a deeper level. During their next supervision session, Abby reports great progress at experiencing intermittent unconditional positive regard for Jorge and is enthused about working with him in the future.

One way to enhance your ability to experience unconditional positive regard is to have a supervisor who accepts your frustrations and intermittent judgmental-ness. If the issues that arise in therapy are similar (or parallel) to the issues that arise in supervision, it’s referred to as parallel process (Searles, 1955). This is one reason why when you get a dose of unconditional positive regard in supervision, it may help you pass it on to your client.

 

John Rap

Counseling and Psychotherapy Theory and Practice, Personal Reflections, Writing

Neuroscience New Year’s Resolutions for 2016

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In case you forgot or never knew, 1990 to 2000 was championed as the decade of the brain. You would think one decade would be enough, but judging by how much of a darling neuroscience is in the media, it looks like the brain will be hogging the whole 21st century too. And so in celebration of our perpetually “New Brain Science,” I’m offering six neuroscience-based New Year’s resolutions for 2016

1. For years, the Dali Lama has been advising everyone to develop a “Loving Kindness” meditation practice. Even if his advice doesn’t change the world, having a consistent loving kindness meditation practice can change your brain. Mindfulness meditation strengthens a region in the brain called the insular cortex, an area broadly linked to self-control and good judgment. This makes 2016 a good time to start meditating. We could all use a little more self-control and good judgment.

2. You should sit down for this one. Or stand up. And then sit down again. This is because scientific research supports brain-body connections. Exercise facilitates everything from sleep to sex. If you want a sharper brain for 2016, then stand-up and get walking or stretching or running or lifting or dancing your way to clearer thinking.

3. Last year might have been the year of the gut. There’s been plenty of talk about the “gut” being our second brain. Of course, this isn’t about growing your gut or striving for a dad-bod. It’s all about digestive health. The best way to get your second brain to support your mental health is to feed it whole, fresh foods, probiotics, and fermented foods (like kombucha, sauerkraut, and kimchee), while avoiding the evils of eating highly processed white sugar/white flour.

4. Exercise is great and good sex may be better, but loving and gentle touch is the bomb. Make 2016 the year—not only for consensual hugs and kisses—but also for shoulder and neck and foot massages. You can even put brushing each other’s hair on your “this-just-might-improve-my-mental-health” to-do list.

5. In 2015 sleep research was hot. It’s more obvious than ever that sleep deprivation is generally bad for your brain; it contributes to clinical depression, suicide, accidents, and illness. Finding a way to sleep well in 2016 means turning off your screens at least 30 minutes before bedtime, cutting out the caffeine after 2pm, and establishing a steady personal and family sleep routine. Sleep is the new black.

6. For those of us in the helping professions, the biggest neuroscience news is all about what psychotherapists call empathic listening. Turns out, listening in an effort to understand others grows the brain in ways similar to mindfulness meditation. That means the more you practice listening with empathy, the more you’ll grow that all-important insular cortex . . . and the more you grow your insular cortex, the less likely you are to engage in violent behaviors that threaten the planet. So if you want a more peaceful planet, put empathic listening on your New Year’s resolution list.

There’s one big principle that underlies all of the new brain science: Whatever behaviors you rehearse, practice, or repeat, are likely to strengthen your skills and grow your brain in those particular regions. What this means is that if your goal is to be a couch potato for 2016, you should spend lots of time couch potatoing so you can develop mad skills in that area, with a neurological net to match. On the other hand, if you want a healthy brain and body and awesome friendships and romance in your life, you should engage in the activities listed above—especially the mindfulness meditation and empathic listening—and you’ll grow a brain and skills that just might bring health, love, and peace in 2016.

Note: I submitted this awesome resolution list to a couple newspapers just before the New Year, but only got rejections. And so I decided to submit it to myself and, voila!, it got published right here on my very own blog (smiley face). Please share and pass it on so that all the newspaper editors who keep rejecting my work start feeling the deep regret they deserve.

Outstanding in Field

 

Clinical Interviewing

Can Mental Health Professionals Predict Violent Behavior in Schools and Agencies?

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Not surprisingly, violence has been on my mind lately. And so when I reached the Violence Risk Assessment section of the Clinical Interviewing text revision, I decided to cut and paste it here. It doesn’t immediately answer the question of whether mental health professionals can predict violence and so if you’re impatient and prefer to stop reading now, the answer to that question is, more or less, “No.”

Assessment and Prediction of Violence and Dangerousness

During an assessment interview, John had the following exchange with a 16-year-old client.

John: I hear you’ve been pretty mad at your shop teacher.

Client: I totally hate Mr. Smith. He’s a jerk. He puts us down just to make us feel bad. He deserves to be punished.

John: You sound a little pissed off at him.

Client: We get along fine some days.

John: What do you mean when you say he “deserves to be punished”?

Client: I believe in revenge. Really, I feel sorry for him. But if I kill him, I’ll be doing him a favor. It would end his miserable life and stop him from making other people feel like shit.

John: So you’ve thought about killing him?

Client: I’ve thought about walking up behind him and slitting his throat.

John: How often have you thought about that?

Client: Just about every day. Whenever he talks shit in class.

John: And exactly what images go through your mind?

Client: I just slip up behind him while he’s talking with Cassie [fellow student] and then slit his throat with a welding rod. Then I see blood gushing out of his neck and Cassie starts screaming. But the world will be a better place without his sorry ass tormenting everybody.

John: Then what happens?

Client: Then I guess they’ll just take me away, but things will be better.

John: Where will they take you?

Client: To jail. But I’ll get sympathy because everyone knows what a dick he is.

During an initial interview or ongoing therapy, clients may describe aggressive thoughts and images. Some clients, as in the preceding example, will be concise about their thoughts, feelings, and images. Others will be less clear. Still others will be evasive and will avoid telling you anything about violent thoughts or intentions.

Assessing for violence potential is similar to assessing for suicide potential; it’s a stressful responsibility and predicting violence is extremely difficult. However, similar to suicide assessment, we still have a legal and ethical responsibility to conduct violence or dangerousness assessments that meet professional standards.

Over the years, there have been arguments about how to most accurately predict violence (Hilton, Harris, & Rice, 2006). Essentially, there are three perspectives.

1. Some researchers contend that actuarial prediction based on specific, predetermined statistical risk factors is consistently the most accurate procedure (Quinsey, Harris, Rice, & Cormier, 2006).

2. Some clinicians believe that because actuarial variables are dimensional and interactive with individual and situational characteristics, prediction based on the clinician’s experience and intuition is most accurate (Cooke, 2012).

3. Others take a moderate position, believing that combining actuarial and clinical approaches is best (Campbell, French, & Gendreau, 2009).

Researchers have consistently reported that actuarial approaches to violence prediction are more accurate than clinical judgment (Monahan, 2013). However, actuarial violence prediction is not without its flaws (Szmukler, 2012; Tardiff & Hughes, 2011).

Narrowing in on Particular Violent Behaviors

Researchers who investigate actuarial assessment protocols have reported that different violent behaviors are associated with unique predictor variables. Below, we provide three examples of violence predictors for three different specific violent behaviors or populations. The goal is to sensitize you to different violent behavior patterns.

Fire-setting. Fire-setting is a particular dangerous behavior that may or may not be associated with interpersonal violence. Nonetheless, depending on your work setting and the clinical population you serve, you may find yourself in a situation in which you need to decide whether to warn a family or potential victim about possible fire-setting behavior.

Mackay and colleagues (2006) reported on specific behaviors included on a fire-setting prediction assessment. They identified the following variables—in decreasing order—as predictive of fire setting:

  •  Younger age at the time of the first fire-setting behavior.
  • A higher total number of fire-setting offenses.
  • Lower IQ.
  • Additional criminal activities associated with the index (initial) fire.
  • An offender acting alone in setting the initial fire.
  • A lower offender’s aggression score. (Interestingly, offenders with higher aggression scores were more likely to be violent, but less likely to set fires.)

We focus first on fire setting here because fire-setting predictors illustrate a general violence-prediction principle. Past violence is a reasonably good predictor of future violence only with regard to specific past and future violence. For example, future fire-setting potential is best predicted by past fire-setting behavior. Similarly, future physical aggression is best predicted by past physical aggression. But a history of physical aggression is not a good predictor of fire setting.

Homicide Among Young Men. Loeber and associates (2005) conducted a large-scale landmark study of homicide among young men living in Pittsburgh. This study is notable because it was both prospective and comprehensive; the authors tracked 63 risk factor (predictor) variables in 1,517 inner-city youth. Obviously, even this large-scale study is limited in scope, and technically the results cannot be generalized beyond inner-city Pittsburgh youth. Nevertheless, the outcome data are interesting and lend insight into risk factors that might contribute to homicidal violence in other populations.
Results from the study indicated that violent offenders scored significantly higher than nonviolent offenders on 49 of 63 risk factors across domains associated with child, family, school, and demographic risk factors. The range and nature of these predictors were daunting. The authors reported:

. . . predictors included factors evident early in life, such as the mother’s cigarette or alcohol use during pregnancy, onset of delinquency prior to 10 years of age, physical aggression, cruelty, and callous/unemotional behavior. In addition, cognitive factors, such as having low expectations of being caught, predicted violence. Poor and unstable child-rearing factors contributed to the prediction of violence, including two or more caretaker changes prior to 10 years of age, physical punishment, poor supervision, and poor communication. Undesirable or delinquent peer behavior, based either on parent report or self-report, predicted violence. Poor school performance and truancy were also among the predictors of violence. Finally, demographic factors indicative of family disadvantage (low family SES, welfare, teenage motherhood) and residence in a disadvantaged neighborhood also predicted violence. Among the proximal correlates associated with violence were weapon carrying, weapon use, gang membership, drug selling, and persistent drug use. (p. 1084)

Homicidal violence was best predicted by a subset of general violence predictor variables. Specifically, homicide was predicted by “the presence or absence of nine significant risk factors:

• Screening risk score
• Positive attitude to substance use
• Conduct disorder
• Carrying a weapon
• Gang fight
• Selling hard drugs
• Peer delinquency
• Being held back in school
• Family on welfare (p. 1086).

In particular, boys who had at least four of these nine risk factors were 14 times more likely to have a future homicide conviction than violent offenders with a risk score less than four.

Violence and schizophrenia. In and of itself, a diagnosis of schizophrenia doesn’t confer increased violence risk. Instead, research indicates there are specific symptoms—when seen among individuals diagnosed with schizophrenia—associated with increased risk. These symptoms include severe manifestations of:

  • Hallucinations
  • Delusions
  • Excitement
  • Thinking disturbances. (Fresán, Apiquian, & Nicolini, 2006)

This research suggests that clinicians should be especially concerned about violence when clients diagnosed with schizophrenia have acute increases in the intensity and frequency of their psychotic symptoms.

Research versus Practice

For a short guide to predicting violence, see a previous post: https://johnsommersflanagan.com/2013/02/25/guidelines-for-violence-risk-assessment/

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Counseling and Psychotherapy Theory and Practice

Constructivism vs. Social Constructionism: What’s the Difference?

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This is an excerpt from the beginning of Chapter 11 of Counseling and Psychotherapy Theories in Context and Practice (3rd  ed., John Wiley & Sons, 2018). Despite the heavily intellectual content and use of the traditional sex binary, I hope you’ll find this way of defining these two different post-modern perspectives helpful, and I hope you get the joke at the end.

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The best way to begin a chapter on constructive theory and therapy is with a story.

Once upon a time a man and a woman met in the forest. Both being academic philosophers well-steeped in epistemology, they approached each another warily. The woman spoke first, asking, “Can you see me?”

The man responded quickly: “I don’t know,” he said. “I have a plethora of neurons firing in my occipital lobe and, yes, I perceive an image of a another person and I can see your mouth was moving precisely as I was experiencing auditory input. Therefore, although I’m not completely certain you exist out there in reality—and I’m not completely certain there even is a reality—I can say without a doubt that you exist … at least within the physiology of my mind.”

Silence followed.

Then, the man spoke again,

“Can you hear me?” he asked.

The woman responded: “I’m not completely certain about the nature of hearing and the auditory process, but I can say that in this lived moment of my experience I’m in a conversation with you and because my knowledge and my reality is based on interactive discourse, whether you really exist or not is less important than the fact that I find myself, in this moment, discovering more about myself, the nature of the world, and my knowledge of all things.”

There are two main branches of constructive theory. These branches are similar in that both perspectives hold firmly to the postmodern idea that knowledge and reality are subjective.

What is Constructivism and What is Social Constructionism?

Constructivism, as represented by the man in the forest, includes people who believe knowledge and reality are constructed within individuals. In contrast, social constructionism, as represented by the woman in the forest, includes people who believe knowledge and reality are constructed through discourse or conversation. Constructivists focus on what’s happening within the minds or brains of individuals; social constructionists focus on what’s happening between people as they join together to create realities. Guterman (2006) described these two perspectives:

Although both constructivism and social constructionism endorse a subjective view of knowledge, the former emphasizes individuals’ biological and cognitive processes, whereas the latter places knowledge in the domain of social interchange. (p. 13)

In this chapter, just as you might avoid traditional “constructed” gender binaries, we de-emphasize distinctions between constructivist and social constructionist perspectives. Mostly, we lump them together as constructive theories and therapies and emphasize the intriguing intervention strategies developed within these paradigms. This may upset staunch constructivists or radical social constructionists, but we take this risk with full confidence in our personal safety—because most constructive types are nonviolent, strongly preferring to think, write, and engage in intellectual discussion. Therefore, within our own socially or individually constructed realities, we’ve concluded that we’re in no danger of bodily harm from angry constructive theorists or therapists.

Clinical Interviewing, Counseling and Psychotherapy Theory and Practice, Parenting

Doing an Internet Interview on IHeart Radio

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Today I did an internet interview with Dr. Carlos Vazquez on his “Circle of Insight” show on IHeart Radio. A few minutes after we finished, I got an email from Dr. Carlos indicating it was posted and ready to hear. Wow. Technology is amazing and it’s especially amazing when it works.

Here’s the link to the interview. Check it out if you like. Or ignore it if you prefer.

https://www.spreaker.com/episode/7224462

The show is titled: A discussion about Psychological Theories and how to talk to parents so they Listen with Dr. Sommers-Flanagan

This is what I look like when I do radio interviews.

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Clinical Interviewing, Cool Counseling, Counseling and Psychotherapy Theory and Practice, Multicultural, Therapy with Adolescents

Counseling Culturally Diverse Youth: Research-Based and Common Sense Tips

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This is a rough preview of a section from the 6th edition Clinical Interviewing. As always, your thoughts and feedback are welcome.

Counseling Culturally Diverse Youth: Research-Based and Common Sense Tips

Research on how to practice with culturally diverse youth is especially sparse. To make matters more complex, youth culture is already substantially different from adult culture. This means that if you’re different from young clients on traditional minority variables, you’ll be experiencing a double dose of the cultural divide. These complications led one writer to title an article “A knot in the gut” to describe the palpable transference and countertransference that can arise when working with race, ethnicity, and social class in adolescents (Levy-Warren, 2014).

To help reduce the size of the knot in your gut, we’ve developed a simple research- and common-sense list to guide your work with culturally diverse youth (Bhola & Kapur, 2013; Norton, 2011; Shirk, Karver, & Brown, 2011; Villalba, 2007):

1. Use the interpersonal skills (e.g., empathy, genuineness, respect) that are known to work well with adult minority group members. Keep in mind that interpersonal respect is an especially salient driver in smoothing out intercultural relationships.

2. Find ways to show genuine interest in your young clients, while also focusing on their assets or strengths.

3. Treat the meeting, greeting, and first session with freshness and eagerness. There’s evidence that young clients find less experienced therapists easier to form an alliance with.

4. Use a genuine and clear purpose statement. It should capture your “raison d’etre” (your reason for being in the room). We like a purpose statement that’s direct and has intrinsic limits built in. For example: “My goal is to help you achieve your goals . . . just as long as your goals are legal and healthy.” One nice thing about this purpose statement is that sometimes young clients think the “legal and healthy” limitations are funny.

5. Don’t use a standardized approach to always talking with youth about your cultural differences. Instead, wait for an opening that naturally springs up from your interactions. For example, when a teen says something like, “I don’t think you get what I’m saying” it’s a natural opening to talk about how you probably don’t get what the youth is saying. Then you can discuss some of your differences as well as you’re desire to understand as much as you can. For example: “You’re right. I probably don’t get you very well. It’s obvious that I’m way older than you and I’m not a Native American. But I’d like to understand you better and I hope you’ll be willing to help me understand you better. Then, in the end, you can tell me how much I get you and how much I don’t get you.”

6. Provide clear explanations of your procedure and rationale and then linger on those explanations as needed. If young clients don’t understand the point of what you’re doing, they’re less likely to engage.

7. Be patient with your clients; research with young clients and diverse clients indicate that alliance-building (and trust) takes extra time and won’t necessarily happen during an initial session

8. Be patient with yourself; it may take time for you to feel empathy for young clients who engage in behaviors outside your comfort zone (e.g., cutting)

I hope these ideas can help you make connections with youth from other cultures. The BIG summary is to BE GENUINE and BE RESPECTFUL. Nearly everything else flows from there.

Uncategorized

Take Me Home, West Virginia (and the platform for my presidential campaign)

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Today, I finally found the best place to announce my candidacy for the President of the United States. It happened at the annual fall conference of the West Virginia School Counselor Association. I know what you’re thinking: There are hardly any better places than Charleston, West Virginia to spontaneously get a presidential campaign rolling.

My presidential ambitions probably won’t get me into the next Democratic or Republican debates. In fact, after announcing my intentions and getting a few responsive chortles, none of the West Virginians EVER mentioned it the rest of the day. It was just like the fall of 1974, when, as a senior and captain of my high school football team, I tripped during the opening celebratory introductions and fell flat on my face. Being embarrassed, angry, and disoriented . . . I exited sideways through the tunnel of fans. It was a bad omen for our season; we lost all 10 games. The incident was so exquisitely humiliating that NO ONE, not my parents, not my friends, not my coaches, and not even my arch enemies, EVER spoke of it. Some things are best left in the past where they belong.

As a part of my presidential announcement, I shared my political platform.

The road to economic vitality . . .
The road to environmental sustainability . . .
The road to excellence in health care and social support programs . . .
And the road to good government . . . always has and always will run through education.

Education isn’t part of a civil society. It’s the essence of a civil society. Knowledge is power. Knowledge is peace. Knowledge is justice. Knowledge is dignity. Knowledge creates the awareness that makes all these things possible. To quote Thomas Jefferson, “I hold these truths to be self-evident.”

It may be no surprise to find out that I’ve made this speech before. Nobody ever really listens. But it might be a surprise to learn that way back in 1775, John Adams the great architect of the American Revolution (and our 2nd President), articulated a similar belief. He wrote:

“Laws for the liberal education of youth, especially for the lower classes of people, are so extremely wise and useful that to a humane and generous mind, NO EXPENSE FOR THIS PURPOSE WOULD BE THOUGHT EXTRAVAGANT” (McCullough, 2001, p. 103; the ALL CAPS are added for emphasis).

Even though they seemed unmoved by my campaign-launching announcement, in the moment, the West Virginians were fabulously supportive. That might have been because I promised, if elected, that I’d get them all the raises they deserve. They responded with applause. Now I understand why being a politician is linked to lying. I liked it when they clapped. I was tempted to keep on lying to keep them clapping.

But they do deserve raises. And their students deserve more school counselors. We have too little funding for schools ACROSS THE BOARD. So, why hasn’t that come up in any presidential debates? Why don’t any American politicians currently view the value of education as self-evident? Do Americans REALLY THINK we can perpetually underfund education and maintain health, humanity, and a functional government? I hope not. We can’t.

But the real purpose of this blog post—other than to kick-start my campaign donations—is to say thanks to the superb school counselors of West Virginia. It was a great day. It was an honor and a privilege to spend time with you. In particular, I owe BIG THANKS to Iestyn Bright and Christine Schimmel for making my appearance in Charleston possible.

And so, in conclusion, the keynote powerpoints are available here: WVSCA No Photos

And the break out session powerpoints are here: How to Listen for WVSCA No Photos

And a selfie of me with my new presidential campaign staff is here:

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Uncategorized

Why is it so Easy to be Judgmental and so Hard to be Accepting? Reflections on Lamar Odom and Neighbors

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I was writing today about unconditional positive regard. It’s such a warm and fuzzy and nice concept. We should always strive to accept the other person as a valuable and separate entity. Of course, that’s impossible. Even Rogers referred to “unconditional positive regard” as “an unfortunate phrasing” because the best we can hope for is intermittent positive regard.

Then, while writing about Rogers, I received a link in my email to an article about Lamar Odom. In case you’re not aware, Odom is the NBA basketball player in the news lately because he’s in the hospital after having a drug overdose at a brothel.

Here’s the link: https://www.thenation.com/article/lamar-odom-deserves-better/

Then I read the article. And I recognized (again, for the seven millionth time) how easy it is to immediately judge another person—especially based on some quick media information. I always seem to rush to judgment . . . instead of thinking that there’s probably a better, more understanding, and more compassionate way of thinking about that person, in this case, Lamar Odom.

Living life in reality is much more difficult than living a life “in theory.” Many mornings I wake up feeling profound acceptance and connection. In that moment, I think I love everybody. And so while lying in bed, I commit myself to being perfectly accepting, loving, and compassionate. Typically, after getting up, I can’t sustain this commitment more than 15 minutes before judgmental thoughts begin raining on my acceptance parade. What makes it so hard to be accepting? What makes it so easy to judge others?

Of course, we shouldn’t judge Lamar Odom based on what we know of him from the media. That’s obvious. But even more importantly, we shouldn’t even judge our neighbors based on our direct experiences with them. There’s nearly always more to the story.

There’s nearly always more room for compassionate acceptance.

And besides the fact that we should all practice more compassionate acceptance just because . . . it’s also true that judging our neighbors too harshly almost always just ends up creating one sort or another of unpleasantness. It might be worth avoiding all that.

So, tomorrow, for my birthday, my goal is to make it 16 minutes into the day before the judgments start. Then I’ll have a real reason to celebrate.

John Casual

Uncategorized

Don’t let your Philosophical Beliefs Make you Less Professionally Competent

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This is just a short rant that may find itself a home in a Putting It in Practice Box of the 6th Edition of Clinical Interviewing.

Over the years I’ve noticed students and professionals sometimes eschew what they view as the cold and rigid application of behaviorism in therapy. This is problematic for two big reasons. First, behavioral science isn’t necessarily cold and rigid. When applied to human clients, it can—and should be—warm and flexible. The idea that behaviorally informed therapists must be cold and rigid is patently false. They can be, but then they’re just being bad therapists.

Second, behavioral principles are operating everywhere all the time. Ignoring them won’t make them go away. Behavioral principles are so ubiquitous that we now label behavioral ignorance as “backward behavior modification” (Sommers-Flanagan & Sommers-Flanagan, 2011, p. 39). Backward behavior modification occurs when individuals unintentionally reinforce undesirable behavior and ignore or punish desirable behavior. This often happens with parents and families and within individuals. Occasionally I want to shout out things like: “Of course you’re having trouble controlling your anxiety . . . IT’S BECAUSE YOU KEEP REWARDING YOURSELF FOR BEING ANXIOUS!!”

I’m not saying you shouldn’t be broadly existential or compassionately person-centered or dogmatically eclectic. You can be those and more. I’m also not saying everyone should become behavior therapists. That’s a dreadfully depressing idea. Our point: Please, don’t ignore one of the foundational sources of knowledge in the helping professions. We ARE social and behavioral scientists. And although sometimes the science doesn’t fit, if you ignore behavioral principles out of an allegiance to an alternative philosophical perspective, you do so at the expense of your own competence. Even worse, you do so at the expense of your clients’ welfare.

Mary Cover Jones

This is a photo of Mary Cover Jones. She was a behaviorist. She was neither cold nor rigid. Just thought you should know.