All posts by johnsommersflanagan

Clinical Interviewing

Psychic Communications . . . and Cultural Differences in Mental Status

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You may or may not have noticed that I haven’t posted anything on this blog in the past 10 days or so. This is because I’ve been experimenting with my telepathic (psychic) communication abilities. As it turns out, my telepathy skills aren’t as refined as I wish they were and so instead of any specific communications from me, receivers have only experienced warm and fuzzy positive sensations. And so if you experienced anything positive like that over the past ten days, it probably means I was thinking of you and trying to psychically send you some pleasant holiday wishes.

Below please find another installment in my intermittent Mental Status Examination series. This posting includes an activity you can use yourself or with a class to facilitate a discussion (with yourself or among class members) about cultural differences in mental status.

Happy New Year! and Happy Mental Statusing!!

Cultural Differences in Mental Status

Part One: Cultural norms must be considered when evaluating mental status. In the following Table, read through the MSE category, the MSE observation, and then contemplate the “invalid conclusion” along with the “explanation.” The purpose of this activity is to illustrate how cultural background and context can affect the meaning of specific client symptoms.

Category Observation Invalid Conclusion Explanation
Appearance Numerous tattoos and piercings Antisocial tendencies Comes from region or area or subculture where tattoos and piercings are the norm
Behavior/psychomotor activity Eyes downcast Depressive symptom Culturally appropriate eye-contact
Attitude toward examiner Uncooperative and hostile Oppositional-defiant or personality disorder Has had abusive experiences from dominant culture
Affect and mood No affect linked to son’s death Inappropriately constricted affect Expression of emotion about death is unaccepted in client’s culture
Speech and thought Fragmented and nearly incoherent speech Possible psychosis Speaks English as third language and is under extreme stress
Perceptual disturbances Reports visions Psychotic symptom Visions are consistent with Native culture
Orientation and consciousness Inability to recall three objects or do serial sevens Attention deficit or intoxication Misunderstands questions due to language problem
Memory and intelligence Cannot recall past presidents Memory impairment Immigrant status
Reliability, judgment, and insight Lies about personal history Poor reliability Does not trust White interviewer from dominant culture

Part Two: For each category addressed in a traditional MSE, try to think of cultures that would behave very differently but still be within “normal” parameters for their cultural or racial group. Examples include differences in cultural manifestations of grief, stress, humiliation, or trauma. In addition, persons from minority cultures who have recently been displaced may display confusion, fear, distrust, or resistance that is entirely appropriate to their situation.

Work with a partner to generate possible MSE observations, in addition to those listed in Part One of this Multicultural Highlight and using the Table below, that might lead you to an inappropriate and invalid conclusion regarding client mental status.

Category Observation Invalid Conclusion Explanation
       
       
       

This Table is adapted from the text, Clinical Interviewing, by John and Rita Sommers-Flanagan: http://www.amazon.com/Clinical-Interviewing-2012-2013-John-Sommers-Flanagan/dp/1118390113/ref=la_B0030LK6NM_1_1?ie=UTF8&qid=1357167677&sr=1-1

 

Parenting, Therapy with Adolescents

The Seven Magic Words for Parents

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Children become adults by practicing. Some of this practicing involves having the right to make choices, even bad and painful choices. For parents who have not learned to back down, we offer the seven magic words. These are words derived from our study of choice theory (Glasser, 1998, 2002). The good news is that by using these words parents can share their thoughts, feelings, and wishes with their children in way that might help a rebellious child hear their viewpoint. The bad news is that after carefully expressing themselves, parents then acknowledge that ultimately, compliance is not mandatory. And there’s even more bad news:  These words aren’t really magic and parents will need more than seven of them to make them work at all.

The seven magic words are a frame for direct, powerful, and noncontrolling communication. They are: “I want you. . . but it’s your choice.” These framing words allow parents to express whatever they want (we encourage positive words) while at the same time acknowledging their child’s power and right to self-determination. By explicitly acknowledging their children’s right to self-determination, parents may reduce their children’s need to prove their independence. Examples of the seven magic words in action include:

  • I want you to stay clean and sober at the party tonight because I love you, and I know if you get caught, you might end up kicked off the basketball team, and also, your dad and I can’t trust you with the car if we know you drink, but of course I know I can’t control you, so it’s your choice.
  • I want you to graduate from high school, go to college, have a great job, and get rich, but whether or not that happens is really up to you.
  • You know I want you to be healthy, eat well, and exercise, but whether you do that is your business. I’ll help you any way I can, but it’s your choice.

As you can see, the magic words are a frame for parents to express their own beliefs and convictions. This technique allows parents to directly express heartfelt feelings, and even describe the consequences they fear, but to then turn the choice back over to the child.

Some parents will be disappointed with the seven magic words. They wish for true magic and true control. Instead, this frame merely offers an opportunity to briefly and succinctly communicate personal and family values directly to children. In many families, one of these values is to acknowledge and honor the children’s individual freedom and ultimate rights to choose how to live their lives.  Most parents want their children to learn how to make responsible, life-enhancing choices.

Go to http://www.wiley.com/WileyCDA/WileyTitle/productCd-1118012968.html to purchase a copy of “How to Listen so Parents will Talk and Talk so Parents will Listen as an excellent, but belated, holiday gift for someone you love:).

Counseling and Psychotherapy Theory and Practice, Parenting, Personal Reflections, Therapy with Adolescents

Talking with Kids about Trauma and Tragedy

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             All too often, very bad and traumatic things happen in the world. Many of these terrible things find their way into the news. This can be shocking and depressing not only for the people who were directly affected, but also for the general public. We are often repeatedly exposed to words and images that can trigger emotional and behavioral reactions in adults and children. Below is a short list with brief descriptions of how adults can help children deal effectively with traumatic information from the news and other media sources.

TALKING WITH CHILDREN: CONVERSATIONS ABOUT REALITY

The first step in talking with children is always the opposite of talking. LISTEN. Listen for how children have been affected. Listen for what they’ve seen and heard. Listen for their fears and fantasies. Listen for their personal coping strategies and solutions.

It’s important to listen closely, but if you listen too hard for children to talk about trauma, you run the risk of making them think they SHOULD be traumatized. If this happens, then children often will start giving you what they think you want . . . they’ll start talking about trauma. Therefore, a big challenge for adults is to listen in a balanced way.  Don’t spend too much time everyday encouraging children to talk about their deepest fears. If you do, it’s possible that everyone will get more and more scared — including you!

Perhaps the biggest deal when talking with kids about real tragic events, is being able to answer their questions. They may ask you terribly hard questions, like, “Will there be a plane crashing in our neighborhood?” or “Do you think a shooter might come to our school?” or “Will I be safe at home?” or “Teacher, are you scared?”

Children often ask very good and very hard questions. An important guideline for teachers, parents, and counselors is to stay balanced. This means you can admit to being scared — as long as you also admit to being strong. Some children can quickly pick up on false reassurance, which is one reason why I’m not in agreement with Dr. Joyce Brothers who suggested after 9/11 that it was a good time to lie to your children. Instead, I recommend acknowledgement that the world is not always a safe place, but that you’ll do everything you can to be strong and help keep the child or children safe.

With preschoolers, there are some conversational topics that are best to avoid. For example, there’s no need to go into graphic detail about specific injuries, etc.  This is similar to the fact that very young children don’t need to know all the details about sexuality. It’s better to speak generally about violence and destruction. It’s also very important to protect your children from too much exposure to media coverage of violent events.

It’s also important to never forget about focusing on children’s strengths. Listening first provides you with a foundation for giving children feedback about their strengths. Be sure to listen for children’s strengths . . . and then reflect them back. You can also encourage children to tell you about their strengths – including both ways they’ve handled hard things in the past and ways they might handle hard things in the future.

 PLAYING WITH CHILDREN: REENACTMENT, PRETEND PLAY, AND MASTERY

Younger children will typically play out or reenact their traumatic experiences. For preschoolers pretend play will be the dominant way they deal with the trauma of what they’ve seen and heard. Around 9/11 children were likely to build towers and have them knocked down. They also enacted play activities involving airplanes, police, terrorists (or other “evil/bad” people). If they’ve been exposed to images and heard about school shootings you might see some play activities involving guns and death and loss. For the most part, it’s best to just sit back and watch children as they enact these scenes. By allowing them un-directed play time and some nondirective commentary, you’ll be helping them take their first steps toward healing (more information on non-directive play is included on the “Special Time” tip sheet on this blogsite).

On the other hand, sometimes children get stuck in the same repeated play pattern. This more chronic form of play is referred to as post-traumatic play. When children seem genuinely stuck repeating pretend interactions through non-interactive play that provides no apparent gratification, you may need to interact with them in ways that help them get un-stuck. You might want to try these strategies: (a) have the child stand up and take some deep breaths before resuming play; or (b) interact with the child in a way that disrupts the pattern (for example, you might ask, “what would happen if . . . ?”).

Obviously, rigid post-traumatic play patterns indicate a need for professional assistance.

 DRAWING WITH CHILDREN:  CAPTURING THE FEAR ON PAPER

Children’s fears can seem big and intimidating. That’s true for people of any age. Maybe that’s why, for adults and older children, writing about specific fears and trauma can be so helpful. Somehow, writing things down on paper can help to put it in perspective.

Younger children aren’t able to use the written word effectively for personal journaling. That’s where drawing comes in. When children color, draw, paint, or sculpt their fears, the fears become more manageable.

 STORYTELLING STRATEGIES

Storytelling is a very powerful tradition and technique for dealing with many human problems and challenges. Stories can be designed or obtained through published materials. In response to tragedy, it can be helpful for children to hear stories of bravery under difficult or perilous conditions.

If you choose to invent your own stories, be sure to create a story with a main character and a clear beginning, middle, and ending. If you’re comfortable with it, you can even have the children help invent characters and their own stories.

There are many ways to encourage children to make up stories of their own. The advantage of this is that you get to listen for the dynamics of the children’s story and so it provides some assessment information. As a counseling technique, it’s possible to use a pretend radio or television show. You can invite children to be guests on your “show” and interview them about their experience or have them share a story.

 HELPING WITH TRANSITIONS:

Separation anxiety is a common reaction that children have to stressful news or situations. This means children may have trouble saying goodbye to their parents and being left at school or day care. In most cases, it’s best for parents, children, and staff to develop an individualized goodbye and hello routine for drop-offs and pick-ups. These routines will be less necessary as time goes by, but it’s good to have goodbye and hello rituals there when you need them. For example, having a hello and goodbye song, transitional objects, and other objects of comfort can ease the pain of separation.

 HAVING FUN: USING DISTRACTION, HUMOR, AND PLAY TO MOVE PAST TRAUMA

Don’t forget, it’s easy to pay way too much attention to the traumatic news and ignore regular daily play routines. Don’t fall into this trap. It’s good to keep kids active and keep them having fun. It’s good to be prepared with some games, songs, or activities that you can rely on to engage children and help them forget about the bad news for a while.

 LEARNING ACTIVITIES: MASTERY THROUGH EDUCATION, SAFETY, AND SERVICE

Not only does life go on after a trauma; it’s important for life to keep getting better. Ways to move forward include (a) continuing with educational, skill-building, and stress management activities, (b) promoting safety strategies and skills, and (c) involving children in basic service activities . . . possibly even service activities that include teaching other children strategies for coping with trauma or difficult situations.

 GET HELP AS NEEDED

It’s a sign of strength to get help when it’s needed. You may notice specific reactions or experiences in children or yourself that indicate it’s time to for professional assistance. Some of the primary symptoms of trauma and vicarious trauma that can develop in these situations include the following:

  • Repetitive and intrusive thoughts and images.
  • Sleep problems: Insomnia, nightmares, and night terrors.
  • Separation Anxiety and clingy-ness.
  • Specific fears/phobias.
  • Hypervigilence.
  • Regression.

 SELF CARE NOW AND INTO THE FUTURE

Remember to take good care of yourself so you can be of greater help for others. This could involve many different activities including vigorous exercise, maintaining healthy eating and sleeping routines, and scheduling time for social contact and social support.

This Tip Sheet was written by John Sommers-Flanagan, Ph.D., professor of Counselor Education at the University of Montana.

Counseling and Psychotherapy Theory and Practice, Group therapy, Personal Reflections

When Giving Gives Back

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For several years Rita has been having first year counseling students do at least five hours of “volunteer” work with our local day treatment center for clients (or consumers) who struggle with chronic mental disorders. This year Rita is on sabbatical and so the task fell to me. To be honest, I was ambivalent about the assignment, mostly because the logistics seemed challenging. I had to arrange two separate organizational visits to the mental health center for about 15 students with different schedules before the volunteering could start and I struggled to make these happen in a timely manner. I secretly wondered if arranging this experience would be worth the hassle.

On Monday, October 29, I finally met the first group at the Day Treatment program and was emotionally transported back to the early 1980s when I was worked in a Day Treatment program and then as a recreation therapist at a 23-bed private psychiatric hospital. I listened as a staff member gave us the most unstructured orientation ever. He eventually told us that he was a “client” at the center before becoming staff. He told the students they were free to just drop in and hang out whenever. I could feel the students’ anxiety rising at the thought of just hanging out and so I asked a few questions and told a couple stories to take up time and they asked questions of their own. In an odd mix of awkwardness and genuineness and anxiety, I felt the wish to just hang out with the day treatment clients myself.   

But instead of hanging out, the reality of other responsibilities started pressing forward and I left with unresolved emotions. I decided to deal with those emotions by writing a small check to support the River House Day Treatment Member Fund. I wrote the check and sent it off.

After completing their five volunteer hours, our students are required to write a short essay about their experience. Today, I’ve spent much of my day reading these essays. They are amazingly open and appreciative of the experience. Some samples:

“I am always humbled by the willingness of others to not only be open with me and to share with me their experiences but also by the ‘sameness’ of a lot of human experiences and suffering.”

“It felt good to share in the humanness of it all- bad days, favorite things, boyfriends, girlfriends, family, and trying to find meaning even when our stories are so different.”

“The clients were not only positive and loving toward the staff members, but also towards me as a volunteer. Every client I was able to talk to complimented something about me and they were constantly complimenting each other.”

“The clients I talked with accepted me in to their community and openly shared their experiences with me. This allowed me to see the world, in a small way, through their eyes.”

Every essay has emphasized the positive environment, the loving-kindness of staff and patients, and the surprise and joy of making deeply human connections. I also received an excellent formal thank-you note from the program director (for the small donation). In it she enclosed a short note from the clients or members of the Day Treatment Center. They wrote:

Thank you so much for the monetary gift. We appreciate it so much. Your students have blessed us with their presence and we have enjoyed them. I hope that we can give the students a fresh perspective on how a special place such as River House can do good and help its members. I hope you will always feel welcome here and thank you for all you do, mentoring the students and giving gifts to us.

This letter and the feelings I get when I read “Your students have blessed us with their presence . . .” was much bigger than what I gave. That’s the same message I keep getting from my students. They went with minimal expectations, a little angst, and to clock their required hours. But instead of just completing a simple assignment, they received an experience so meaningful that many of them have are extending their volunteer work far beyond the required five hours.

This is a fabulous example of how giving can give back much more than what was originally given. This is probably what Adler meant by Gemeinschaftsguful.

Thank-you to the River House staff and members for . . . BLESSING US with YOUR presence.

Counseling and Psychotherapy Theory and Practice

The Girl Code by Ashley Marallo

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In 1999, William Pollack published a book titled, Real Boys.This book, based on his interviews with adolescent boys, included a list of behaviors he referred to as the “Boy Code.” The Boy Code included boy-related norms like: (a) Stand on your own two feet, (b) never show emotion–except anger, and (c) separate from your mother and all things female ASAP.

When lecturing on feminist theory and therapy, I often include a short review of Pollack’s Boy Code and follow that with a discussion about what might be the American version of a Girl Code. Most years I offer students a few points if they’ll email me their personal rendition of a Girl Code.

The year, Ashley Marallo, M.S.W., who’s currently a doctoral student in our counselor education program sent me her amazing and poetic version of the Girl Code. With Ashley’s permission, here it is:

Be nurturing and passive and loyal. Above all else, sacrifice for others who need you to tend to them. Put your life on hold to be available at the moment they need you. Standby anxiously watching and waiting to be of use. It is why you are loved. Don’t forget you are nothing without me. But I will throw you a bone, the façade of real belonging, and you will be too scared to look for something better. Please me. Be desirable. Put on a show for me. Show me how much you care what I think. Don’t inhabit your body. Detach yourself so you see you through my eyes. Remove all your body hair. Look like a porn star. Be skinny, but still curvy. But eat! Take this and buy yourself something nice. By nice I mean Victoria’s Secret for you to parade around in later for me. Be sexual when I want you to be, anticipate my moods, take charge within the limits of the power I give you, make decisions. Make the right ones. You’re an idiot if you make the wrong one. Obviously you’re not paying attention. Be sorry. You’re so emotional. Crazy. Needy. Clingy. You need help. Need me. I’ll keep you safe. Then trust me and be vulnerable and I’ll make you feel weak and worthless. Be feminine but independent. Your ambition is so cute. So is your anger as long as it bends to mine. I’m not happy. Do something for me. Be responsible for my emotions. Feel bad about it. Come home. Read my mind. Control yourself. You’re like a child. Grow up. All you ever do is think about yourself. Prove yourself. Work harder than everyone else then I’ll approve. Be perfect. Look rested. Glow. Don’t wear too much makeup. You look like a slut. Why did you cut your hair that way? Be graceful. Be beautiful and make it look natural. Don’t cry. It makes your eyes puffy. No one wants to be around you when you are like this. Your job is to make men feel important and special. Your value depends on it. If they want you, go with them. That will give you power. You can make them lose control. Be mysterious and intriguing. Speak intellectually but not over their head. You don’t want them to feel inadequate. A specific level of smartness is sexy. Be fun. Be charming and alluring. Drink and show you can have a good time. But don’t get wasted or throw up. Maintain the precise amount of control over yourself at all times. Be sensitive. Absorb meanness. Forgive them. It’s nice of them to apologize. Don’t be too hard to handle, or too much work. They’ve had a hard day. Go be by yourself when you feel sad. Like the things I like. Look adorable in oversized football jerseys. Hang out with the guys. Let me show you off. Who’s that guy you were talking to at the bar? You probably want to fuck him. Take birth control pills so I don’t have to wear condoms. Get on top. Make out with girls. Watch the kids. If you make it to 17 without having your own, you are doing pretty good. Stay together for the kids. Let them be angry with you. It is your fault it didn’t work after all. If you had just tried harder. Everything’s fine. It’s all in your head. It’s always something. Make me a cup of tea. Avoid conflict. Smooth it over. Just say you’re sorry and it will be ok. Keep the family together. Use sexuality as a weapon. Just the right amount. Don’t talk about it. Lie about how many men you’ve slept with and the size of their penises. They don’t really want to know even when they ask. Make sure you lay down in just the right position that your belly looks flat and your hip bones protrude just enough to create a small shadow. Enjoy strip clubs. It makes you an edgy chic. Agonize over bathing suit season and buy something that costs twice as much as a shirt for a pile of strings half the size. And make sure it makes your boobs look perky. And by the way all women should be able to wear tube tops. Get a tan and pedicures. Our feet are supposed to be cute, small and smooth. Giggle at lewd comments. It’s a compliment. Be a doll. Orbit around your man. Create a nice home for him. Be his mother and his servant. The way to a man’s heart is through his stomach. Be chaste enough to make him wait but marry him if he knocks you up. Continuously ask yourself whether you are an imposter and when you will be found out. Offer to pay but be ready to and hope he picks up the tab. Say thank you for everything you are given even if you earn it. Apologize for everything that goes wrong even if it’s not your fault. Perpetually wonder if you are good enough, not knowing what you’re wondering you are good enough for.

 

Parenting

Backward Behavior Modification

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Understanding backward behavior modification is very important for parents and for professionals who work with parents. In the following short excerpt from our book, “How to Listen So Parents will Talk and Talk so Parents will Listen” we introduce the concept. If you have an opinion about this concept, be sure to comment and share your perspective.

Backward Behavior Modification: Using Boring, Natural, and Logical Consequences and Passionate and Surprise Rewards

As we alluded to in Chapter 4, backward behavior modification is endemic. Not only do parents tend to pay more attention to negative and undesirable behaviors than they do to positive and desirable behaviors, they also tend to do so with greater force or affect—which further complicates the situation. As noted previously, we learned about this complicated problem directly from teenagers who were in trouble for delinquent behaviors (see Chapter 4).

If parents engage in too much anger, yelling, or passion when their children misbehave, several problems can emerge: (1) The child will experience her parent’s passion as reinforcement for misbehavior; (2) the child will feel powerful and in-control of her parent (which is quite strong positive reinforcement); or (3) the parent will feel controlled by the child, or out-of-control, both of which further escalate the parent’s emotional behavior.

To address backward behavior modification problems, we teach parents how to use “Boring Consequences and Passionate Rewards.” The opening case in Chapter 1 is an example of the power of boring consequences. If you recall, the parents of Emma, a very oppositional nine-year-old, reported their “family was about to disintegrate” because of continuous power struggles. However, when they returned for their second consultation session, their family situation had transformed largely as a function of boring consequences. In Chapter 1, we quoted the father’s report on how he found boring consequences to be tremendously helpful. Emma’s mother was similarly positive:

Thinking about and then giving boring consequences helped us see that it was about us and not about our daughter. Before, she would misbehave and we would know she was going to misbehave and so we would go ballistic. Giving boring consequences suddenly gave us back our control over how we reacted to her. Instead of planning to go ballistic, it helped us see that going ballistic wasn’t helping her and wasn’t helping us. It felt good to plan to be boring instead. And the best thing about it was how it made the whole process of giving out consequences much shorter.

The inverse alternative to boring consequences is the practice of passionate rewards. Parents can be encouraged to intentionally pay positive and enthusiastic attention to their children’s positive, desirable, and prosocial behaviors. Passionate rewards include parental responses such as:

  • Applause or positive hoots and hollers
  • Verbal praise (“I am so impressed with your dedication to learning Spanish”)
  • Pats on the back, shoulder massages, and hugs
  • Family gatherings where everyone dishes out compliments

Passionate rewards are especially important for preadolescent children. As you may suspect, because of increased self-consciousness accompanying adolescence, passionate hugs and excessive compliments for a 14-year-old may function as a punishment rather than a reinforcement—especially if the hugging and hooting occurs in front of the 14-year-old’s peers.

Surprise rewards, presuming they’re provided in a socially tactful manner, are extremely powerful reinforcers for children of all ages. For example, with teenagers it can be very rewarding if parents suddenly and without advance notice say something like, “You know, you’ve been working hard and you’ve been so darn helpful that this weekend we’d like to give you a complete vacation from all your household chores or this $20 bill to go out to the movie of your choice with your buddies; which would you prefer?”

Surprise rewards are, in technical behavioral lingo, variable-ratio reinforcements. Across species, this reinforcement schedule has been shown to be the most powerful reinforcement schedule of all. Everyday examples of variable-ratio reinforcement schedules include gambling, golf, fishing, and other highly addictive behaviors where individuals can never be certain when their next response might result in the “jackpot.”

When coaching parents to use surprise rewards (variable-ratio reinforcement schedules), we emphasize that the surprise reward should be viewed as a spontaneous celebration of desirable behavior. Overall, we prefer this informal reinforcement plan over more mechanized sticker charts and reward systems (although we don’t mean to say that these more mechanized systems should never be used; in fact, when children are put in charge of their own reinforcement systems, these systems can be especially effective).

Clinical Interviewing

Another Sample Mental Status Examination Report

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Mental Status Examination (MSE) reports can be more or less detailed. More detailed reports are necessary when patients or clients exhibit a complex array of psychiatric symptoms, affect, and behavior. Less detailed reports are more common when the situation is less complex and the patient or client displays affect and behaviors that are generally within what might be considered a broad range of normal.

In most cases MSEs are imbedded within a clinical or psychiatric interview. As a consequence, as an evaluator, sometimes you may obtain more information about certain areas of functioning than others. This may or may not be intentional and it may or may not be reflected in your report. For example, in the example below, the purpose of the interview was to screen an individual for advanced placement in a Job Corps setting. Because Job Corps is a social and vocational setting, you may notice the MSE report writer emphasizes social functioning. You may also notice that the writer is EXPLICITLY clearly giving the client a “clean” mental status.

Keep in mind that like all MSE reports, this report is designed as a relatively objective appraisal of mental functioning. Nevertheless, subjective judgment and inference is always a part of MSEs and MSE reports.

MSE Sample Report: Example of Positive Functioning

Lucia Rodriguez, a 24-year-old Latino female, was open, pleasant, and cooperative during our meeting. She was well-groomed and looked somewhat younger than her stated age. She was fully oriented and alert. Her speech was clear, coherent, and of normal rate and volume. Her affect was euthymic and stable. She rated her mood as an “8” on a 0-10 scale, with 0 being completely down and depressed and 10 being as happy as possible. She further indicated that she is typically in a “positive mood.” Lucia has no current obsessional thoughts or psychotic symptoms. She has no significant mental health history. Her intellectual ability is probably at least in the above average range. She completed serial sevens and other concentration tasks without difficulty. Her cognitive skills, including memory and abstract thinking were intact. Her responses to questions pertaining to social judgment were positive and well-developed. Overall she appeared forthright and reliable. Her insight and judgment were good.

Uncategorized

Want to Help with Professional Referencing?

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Hi All.

I’ve got a writing project going and could use some help with specific tasks and so I’m posting this “job description” and instructions for applying.

Job Description

• Working from a PC platform (sorry, Macs haven’t worked well for this) and using PsycInfo, identify citations/references (books and articles) to use in the 2013 revision of Clinical Interviewing
• Compile these references in an organized electronic chapter-by-chapter library using RefWorks
• Meet with me in person or over the phone to discuss the references as needed
• Insert the references into the chapters using RefWorks
• Edit the reference lists to be perfectly compliant with APA format
• Available to work up to 5 hours a week from now until Feb 1 (this will likely be quite variable with zero hours some weeks and more other weeks)
• Interest in making $15/hour for this work
• If you don’t have direct experience in this area but you’re capable and motivated, depending on other factors, I may be happy to pay you for the first few hours as you learn how to do this

Application Instructions

Email me at john.sf@mso.umt.edu a short letter/note expressing your interest and any experience you have with the items on the preceding job description list.

John

Counseling and Psychotherapy Theory and Practice

From Boring Theory to Exciting Practice: WACES PowerPoints II

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Mondays are my theories evening this semester. Last night was feminist theory and therapy. We rocked our way through Women & Madness; Kinder, Kuche, and Kurche; and the Broverman et al. study to provide us with a foundation of justified anger which helped raise our collective consciousness and stimulate our instinct to tend and befriend and eventually develop an ethic of caring.

Below is the link to powerpoints from my second presentation at the WACES conference in Portland.

WACES Theories

Clinical Interviewing

The WACES Conference in Portland — Presentation I — The Mental Status Exam and Suicide Assessment

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This post includes the powerpoint slides from my presentation on Teaching the Mental Status Examination and Suicide Assessment at the Western Association of Counselor Educators and Supervisors. It was a very nice conference organized and attended by some awesome Counselor Educators. WACES MSE