Category Archives: Counseling and Psychotherapy Theory and Practice

Volunteers Needed for This Friday, July 16

This Friday, July 16, Rita and I are doing a professional video shoot in Billings, MT. Due to some minor scheduling changes, we suddenly have openings for two last minute volunteers, who are willing to talk about personal issues in the role of clients. Below, I’ve written a short description of what we need. If you happen to be an open-minded person interested in a little psychological discovery, read on . . . .

John and Rita Sommers-Flanagan, authors of Clinical Interviewing, Tough Kids, Cool Counseling, and other professional books, are doing a video shoot on Friday, July 16. The video content will be used for educational purposes, primarily to accompany textbooks and for training mental health professionals. John and Rita have openings for volunteers to participate in two demonstrations in the afternoon of July 16. Each demonstration will involve about 30 min of on-camera time, with additional time for prepping and debriefing. Volunteers will be paid a one-time stipend of $100. A description of the two demonstrations follow:

  1. John will engage a volunteer in a brief (single-session) nightmare treatment. The volunteer should have a real problem with nightmares. The therapeutic demonstration will focus on coping with nightmares and changing or reducing their frequency and intensity.
  2. Rita will demonstrate how current emotions are linked or related to past emotions. The volunteer should have experience with some problematic emotions in their present-life and be willing to explore past connections to current distressing emotions. Anger, sadness, and anxiety are three emotions that work well for this demonstration.

Volunteers should be open and interested in exploring psychological issues. Potential volunteers (we only need two!) should contact John Sommers-Flanagan ASAP at john.sf@mso.umt.edu

Seven Dimensions of Suicide Assessment and Treatment

Here’s a glimpse of what the garden looks like this morning.

In most of life, most of the time, there’s not much completely new or original. People tend to gather inspiration from others and build on or rediscover old ideas. This my way of acknowledging that, although I wish I always had a boatload of original ideas to share in the blog, more often than not, I’m embracing the green new deal and . . . re-using, recycling, and repurposing old ideas.

The following Table describes the seven dimension model that Rita and I use to aid clinicians in conducting assessments and interventions with clients or patients who are suicidal. These seven dimensions aren’t original, but the idea that suicide drivers (and risk/protective factors) can emerge and influence people from any or all of these dimensions is helpful in a more or less original way. Check out the Table to see if it’s useful for you.

Dimension: In this column, we define the dimensionsEvidence-Based Suicide Drivers: In this column, we identify risk factors or suicide drivers that can push or pull individuals toward suicidality. The key to this model is to identify and treat the main sources of distress (aka psychache). In the next columns (not included here), you would find wellness goals and specific interventions.
Emotional: all human emotions.Excruciating emotional distress

Specific disturbing emotions (guilt, shame, anger, sadness)

Emotional dysregulation
Cognitive: All forms of human thought, including imagery.Hopelessness

Problem-solving impairments

Maladaptive thoughts

Negative core beliefs
Interpersonal: All human relationships.Social disconnection and perceived burdensomeness

Interpersonal loss and grief

Social skill deficits

Repeating dysfunctional relationship patterns
Physical: All human biogenetics and physiology.Biogenetic predispositions and physical illness

Sedentary lifestyle; poor nutrition

Agitation, arousal, anxiety

Trauma, nightmares, insomnia
Spiritual-Cultural: All religious, spiritual, cultural values that provide meaning and purpose.Religious or spiritual disconnection

Cultural disconnection or dislocation

Meaninglessness
Behavioral: All human action and activity.Using substances or self-harm for desensitization

Suicide planning, intent, and preparation

Impulsivity
Contextual: All factors outside of the individual that influence human behavior.No connection to place or nature

Chronic exposure to unhealthy environmental conditions

Socioeconomic oppression or resource scarcity (e.g., poverty)

If you’re interested in learning more, our suicide book is available through the American Counseling Association https://imis.counseling.org/store/detail.aspx?id=78174 or through the usual booksellers.

Have a great weekend.

JSF

Strategies for Dealing with Insomnia and Nightmares, Part II

This is part II of a two-part blog. For part I, see Sunday’s post: https://johnsommersflanagan.com/2021/05/23/strategies-for-dealing-with-insomnia-and-nightmares-part-i/

Asking About Trauma

You may have a form to screen clients for a trauma history. However, more often than not, you’ll need to ask directly about trauma, just like you need to ask directly about suicidality. In many cases, as discussed in Chapter 3, it may be beneficial to wait and ask about trauma until the second or third session, or until there’s a logical opportunity. Although insomnia and nightmares don’t always signal trauma, when they co-exist, they provide an avenue to ask about trauma.

Counselor: Miguel, I’d like to ask a personal question. Would that be okay?

Miguel: Okay.

Counselor: Almost always, when people have nightmares about guns and death, it means they’ve been through some bad, traumatic experiences. When you’ve been through something bad or terrible, nightmares get stuck in your head and get on a sort of repeating cycle. Is that true for you?

Miguel: Yeah. I went through some bad shit back in Denver.

Counselor: I’m guessing that bad shit is stuck in your brain and one ways it comes out is through nightmares.

Miguel: Yeah. Probably.

Even when clients know their trauma experiences are causing their nightmares, they can still be reluctant to talk about the details. Physical and emotional discomfort associated with trauma is something clients often want to avoid. To reassure clients, you can tell them about specific evidence-based approaches—approaches that don’t require detailed recounting of trauma or nightmare experiences. Two examples include eye movement desensitization reprocessing (EMDR; Shapiro, 2001) and imagery rehearsal therapy (Krakow & Zadra, 2010). 

Miguel: If I talk about the nightmares, they get more real. I have enough trouble keeping them out of my head now.

Counselor: That’s a good point. But right now your dreams are so bad that you’re barely sleeping. It’s worth trying to work through them. How about this? I’ve got a simple protocol for working with nightmares. You don’t even have to talk about the details of your nightmares. I think we should try it and watch to see if your dreams get better, worse, or stay the same? What do you think?

Miguel: I guess maybe my nightmares can’t get much worse.

Evidence-Based Trauma Treatments

In Miguel’s case, the first step was to get him to talk about his insomnia, nightmares, and trauma. Without details about his experiences, there was no chance to dig in and start treatment. The scenario with Miguel illustrates one method for getting clients to open up about trauma. Other clinical situations may be different. We’ve had Native American clients who were having dreams (or not having dreams, but wishing for them), and we needed to begin counseling by seeking better understanding of the role and meaning of dreams in their particular tribal culture.

 Counselors who work with clients who are suicidal should obtain training for treating insomnia, nightmares, and trauma. Depending on your clients’ age, symptoms, culture, the treatment setting, and your preference, several different evidence-based treatments may be effective for treating trauma. The following bulleted list includes treatments recommended by the American Psychological Association (2017) or the VA/DoD Clinical Practice Guideline Working Group (2017), or both (Watkins et al., 2018).

  • Cognitive Processing Therapy (Resick et al., 2017).
  • Eye-Movement Desensitization Reprocessing (Shapiro, 2001)
  • Narrative Exposure Therapy (Schauer et al., 2011)
  • Prolonged Exposure (Foa et al., 2007).
  • Trauma-Focused Cognitive Behavioral Treatment (Cohen et al., 2012).

Although the preceding list includes the scientifically supported approaches to treating trauma, you may prefer other approaches, many of which are suitable for treating trauma (e.g., body-centered therapies, narrative exposure therapy for children [KID-NET], etc.).

Specific treatments for insomnia and nightmares are also essential for reducing arousal/agitation. Evidence-based treatments for insomnia and nightmares include:

  • Cognitive-Behavioral Therapy for Insomnia (CBT-I; Cunningham & Shapiro, 2018).
  • Imagery Rehearsal Therapy (IRT; Krakow & Zadra, 2010).

Targeting trauma symptoms in general, and physical symptoms in particular (e.g., arousal, insomnia, nightmares) can be crucial to your treatment plan. Addressing physical symptoms in your treatment instills hope and provides near-term symptom relief.

[Check out the whole book for more info: https://imis.counseling.org/store/detail.aspx?id=78174%5D

Strategies for Dealing with Insomnia and Nightmares, Part I

What follows is an excerpt from, Suicide Assessment and Treatment Planning: A Strengths-Based Approach (American Counseling Association, 2021). We address insomnia and nightmares in Chapter 7 (the Physical Dimension). This is just a glimpse into the cool content of this book.

Insomnia and nightmares directly contribute to client distress in general and suicidal distress in particular. In this section, we use a case example to illustrate how counselors can begin with a less personal issue (insomnia), use empathy, psychoeducation, and curiosity to track insomnia symptoms, eventually arrive at nightmares, and then inquire about trauma. Focusing first on insomnia, then on nightmares, and later on trauma can help counselors form an alliance with clients who are initially reluctant to talk about death images and trauma experiences.

Focusing on Insomnia

Miguel was a 19-year-old cisgender heterosexual Latino male working on vocational skills at a Job Corps program. He arrived for his first session in dusty work clothes, staring at the counselor through squinted eyes; it was difficult to tell if Miguel was squinting to protect his eyes from masonry dust or to communicate distrust. However, because the client was referred by a physician for insomnia, he also might have just been sleepy.

Counselor: Hey Miguel. Thanks for coming in. The doctor sent me a note. She said you’re having trouble sleeping.

Miguel: Yeah. I don’t sleep.

Counselor: That sucks. Working all day when you’re not sleeping well must be rough.

Miguel: Yeah. But I’m fine. That’s how it is.

To start, Miguel minimizes distress. Whether you’re working with Alzheimer’s patients covering their memory deficits or five-year-olds who get caught lying, minimizing is a common strategy. When clients say, “I’m fine” or “It is what it is” they may be minimizing.

But Miguel was not fine. For many reasons (e.g., pride, shame, or age and ethnicity differences), he was reluctant to open up. However, given Miguel’s history of being in a gang and his estranged relationship with his parents, the expectation that he should quickly trust and confide in a white male adult stranger is not appropriate.

Rather than pursuing anything personal, the counselor communicated empathy and interest in Miguel’s insomnia experiences.

Counselor: Not being able to sleep can make for very long nights. What do you think makes it so hard for you sleep?

Miguel: I don’t know. I just don’t sleep.

When asked directly, Miguel declines to describe his sleep problems. Rather than continue with questioning, the counselor fills the room with words (i.e., psychoeducation). Psychoeducation is a good option because sitting in silence is socially painful and because multicultural experts recommend that counselors speak openly when working with clients from historically oppressed cultural groups (Sue & Sue, 2016). The reasoning goes: If counselors are open and transparent, culturally diverse clients can evaluate their counselor before sharing more about themselves. As Miguel’s counselor talks, Miguel can decide, based on what he hears, whether his counselor is safe, trustworthy, and credible. 

Counselor: Miguel, there are three main types of insomnia. There’s initial insomnia—that’s when it takes a long time, maybe an hour or more, to get to sleep. They call that difficulty falling asleep. There’s terminal insomnia—that’s when you fall asleep pretty well and sleep until maybe 3am and then wake up and can’t get back to sleep. They call that early morning awakening. Then there’s intermittent insomnia—that’s like being a light sleeper who wakes up over and over all night. They call that choppy sleep. Which of those fits for you?”

Miguel: I got all three. I can’t get to sleep. I can’t stay asleep. I can’t get back to sleep.

Counselor: That’s sounds terrible. It’s like a triple dose of bad sleep.

As Miguel begins opening up, he says “I haven’t slept in a week.” Although it’s obvious that zero minutes of sleep over a week isn’t accurate, for Miguel, it feels like he hasn’t slept in a week, and that’s what’s important.

Exploring Nightmares

After Miguel yawns, the counselor asks permission to share his thoughts.

Counselor: Miguel, if you don’t mind, I’d like to tell you what I’m thinking. Is that okay?

Miguel: Sure. Fine.

Counselor: When someone says they’re having as much trouble sleeping as you’re having, there are usually two main reasons. The first is nightmares. Have you been having nightmares?

Miguel: Shit yeah. Like every night. When I fall asleep, nightmares start.

Counselor: Okay. Thanks. I’m pretty sure I can help you with nightmares. We can probably make them happen less often and be less bad in just a few meetings.

The counselor’s confidence is based on previous successful experiences, including using a nightmare treatment protocol that has empirical support (Imagery Rehearsal Therapy; Krakow & Zadra, 2010). Although evidence-based treatments aren’t effective for all clients, they can establish credibility and instill hope. Nevertheless, Miguel doesn’t immediately experience hope.

Miguel: Yeah. But these aren’t normal nightmares.

Counselor: What’s been happening?

Miguel: I keep having this dream where I’m sticking a gun in my mouth. People are all around me with their voices and shit telling me, “pull the trigger.” Then I wake up, but I can’t get it out of my head all day? What the hell is that all about?”

Counselor: That’s a great question.

When the counselor says, “That’s a great question,” his goal is to start a discussion about all the reasons why someone (Miguel in this case), might have a “gun in the mouth” dream. If Miguel and his counselor can brainstorm different explanations and possible meanings for the dream images, it’s less likely for Miguel to interpret his dream as a sign that he should die by suicide. What’s important, we tell our clients, is to look at many different possible meanings the unconscious or God or the Great Spirit or the universe or indigestion might be sending to the dreamer. To help clients expand their thinking and loosen up on their conclusions about their dream’s meaning, we’ve used statements like the following:

You may be right. Your dream might be about you dying or killing yourself. But our goal is to listen to the message your brain sent you and be open to what it might mean. It’s perfectly normal to think your dream was about you dying by suicide—but that’s not necessarily true. That’s not the way the brain and dreams usually work.               Some counselors use self-disclosure about dreams or nightmares they’ve had themselves. Others offer hypothetical or historical dream examples. Either way, normalizing nightmares helps clients become more comfortable talking about their bad dreams and nightmares.

To be continued . . . NEXT TIME . . . we ask about trauma.

If you’re interested in this content, you can buy the whole darn book from ACA here: https://imis.counseling.org/store/detail.aspx?id=78174

If you want the eBook, you can buy it through John Wiley & Sons: https://www.wiley.com/en-ai/Suicide+Assessment+and+Treatment+Planning%3A+A+Strengths+Based+Approach-p-9781119783619

The eBook is also available through Amazon: https://www.amazon.com/Suicide-Assessment-Treatment-Planning-Strengths-Based-ebook/dp/B08T7VNCMK/ref=sr_1_9?dchild=1&qid=1621798923&refinements=p_27%3AJohn+Sommers-Flanagan%3BRita+Sommers-Flanagan&s=books&sr=1-9

The Hottest New Placebos for PTSD

Let’s do a thought experiment.

What if I owned a company and paid all my employees to conduct an intervention study on a drug my company profits from? After completing the study, I pay a journal about ten thousand British pounds to publish the results. That’s not to say the study wouldn’t have been published anyway, but the payment allows for publication on “open access,” which is quicker and gets me immediate media buzz.

My drug intervention targets a longstanding human and societal problem—post-traumatic stress disorder (PTSD). Of course, everyone with a soul wants to help people who have been physically or sexually assaulted or exposed to horrendous natural or military-related trauma. In the study, I compare the efficacy of my drug (plus counseling) with an inactive placebo (plus counseling). The results show that my drug is significantly more effective than an inactive placebo. The study is published. I get great media attention, with two New York Times (NYT) articles, one of which dubs my drug as one of the “hottest new therapeutics since Prozac.”  

In real life, there’s hardly anything I love much more than a cracker-jack scientific study. And, in real life, my thought experiment is a process that’s typical for large pharmaceutical companies. My problem with these studies is that they use the cover of science to market a financial investment. Having financially motivated individuals conduct research, analyze the results, and report their implications spoils the science.

Over the past month or so, my thought experiment scenario has played out with psilocybin and MDMA (aka ecstasy) in the treatment of PTSD. The company—actually a non-profit—is the Multidisciplinary Association for Psychedelic Studies (MAPS). They funded an elaborate research project, titled, “MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study” through private donations. That may sound innocent, but Andrew Jacobs of the NYT described MAPS as, “a multimillion dollar research and advocacy empire that employs 130 neuroscientists, pharmacologists and regulatory specialists working to lay the groundwork for the coming psychedelics revolution.” Well, that’s not your average non-profit.

To be honest, I’m not terribly opposed to careful experimentation of psychedelics for treating PTSD. I suspect psychedelics will be no worse (and no better) than other pharmaceutic-produced drugs used to treat PTSD. What I do oppose, is dressing up marketing as science. Sadly, this pseudo-scientific approach has been used and perfected by pharmaceutical companies for decades. I’m familiar with promotional pieces impersonating science mostly from the literature on antidepressants for treating depression in youth. I can summarize the results of those studies simply: Mostly antidepressants don’t work for treating depression in youth. Although some individual children and adolescents will experience benefits from antidepressants, separating the true, medication-based benefits from placebo responses is virtually impossible.

My best guess from reading medication studies for 30 years (and recent psychedelic research) is that the psychedelic drug results will end up about the same as antidepressants for youth. Why? Because placebo.

Placebos can, and usually do, produce powerful therapeutic responses. I’ll describe the details in a later blog-post. For now, I just want to say that in the MDMA study, the researchers, despite reasonable efforts, were unable to keep study participants “blind” from whether they were taking MDMA vs. placebo. Unsurprisingly, 95.7% of patients in the MDMA group accurately guessed that they were in the MDMA group and 84.1% of patients in the placebo group accurately guessed they were only receiving inactive placebos. Essentially, the patients knew what they were getting, and consequently, attributing a positive therapeutic response to MDMA (rather than an MDMA-induced placebo effect) is speculation. . . not science.

In his NYT article (May 9, 2021), Jacobs wrote, “Psilocybin and MDMA are poised to be the hottest new therapeutics since Prozac.” Alternatively, he might have written, “Psilocybin and MDMA are damn good placebos.” Even further, he also could have written, “The best therapeutics for PTSD are and always will be exercise, culturally meaningful and socially-connected processes like sweat lodge therapy, being outdoors, group support, and counseling or psychotherapy with a trusted and competent practitioner.” Had he been interested in prevention, rather than treatment, he would have written, “The even better solution to PTSD involves investing in peace over war, preventing sexual assault, and addressing poverty.”

Unfortunately, my revision of what Jacobs wrote won’t make anyone much money . . . and so you won’t see it published anywhere now or ever—other than right here on this beautiful (and free) blog—which is why you should pass it on.

The Root of (Most) Misery

For years I’ve been teaching counseling students that the cause of most emotional and psychological misery can be boiled down to one word. To inflame their competitive spirits, I tell them this powerful word starts with the letter E, and offer prizes to students if they can guess the correct word.

Sadly, no one ever guesses that I’m talking about “Expectation.”

Expectation is, IMHO, the biggest source of bad, sad, and maladaptive emotions. I suffer from my own expectations all the time. Just this morning, while trying to listen to a podcast on a walk, I became irrationally enraged with all things Apple. Why? Because my iPhone podcasting app didn’t work in an elegant, user-friendly manner. Even worse is that I’m fully aware of how silly it is for me to justify holding such high—or even modest—expectations when it comes to technology. I have repeated lived experiences that should have led me to know how often I (and others) are thwarted by technology. I also happily rely on and use technology for many hours every day, and although it feels otherwise, most of the time technology provides . . . my computer powers up, my emails get sent, my phone dials the right number, and magical things like Zoom conferences happen without adverse incident.

Here’s the irony: My expectations thwart my happiness far more often than technology thwarts my personal plans and goals. Nevertheless, I’m eager to throw a childish fit when an app malfunctions, but I continue to barely question my unrealistic expectations despite their predictable adverse emotional outcomes. Funny that (as the Brits might say). I resist blaming and changing that which I have some control over (my expectations), while I let loose with relentless complaints about that which I have little control over (technology).

The fortune in my fortune cookie from dinner with my father gave me a nudge toward recognizing and managing my expectations. Panda Express—not usually where I look for guidance—provided me with the wisdom I seek.

If I were inclined to use the word “wiring” when referring to neural networks (I’m not), I might question whether there’s a glitch in my wiring. However, because I’m pretty certain I’ve got no wires in my brain, I’m going after the glitch in my attitude. Sure, as I pursue my attitudinal glitch, my brain may undergo physical, chemical, and electrical changes, but I suspect the fix will be ever so much more complicated than clipping a wire here, and reconnecting another one there.

Thanks for reading . . .

Cultural Specificity and Universality: An Indigenous Example

These days mostly we tend to orient toward the culturally specific, and that’s a good thing. Much of intersectionality, cultural competency, and cultural humility is all about drilling down into unique and valuable cultural and individual perspectives.

But these are also the days of Both-And.

In contrast to cultural specificity, some theorists—I’m thinking of William Glasser right now—were more known for their emphasis on cultural universality. Glasser contended that his five basic human needs were culturally universal; those needs included: Survival, belonging, power (recognition), freedom, and fun.

Although Glasser’s ideas may (or may not) have universal punch, he’s a white guy, and pushing universality from positions of white privilege are, at this particular point in history, worth questioning. That’s why I was happy to find an indigenous voice emphasizing universal ideas.

I came across a quotation from a Lakota elder, James Clairmont; he was discussing the concept of resilience, from his particular linguistic perspective:

The closest translation of “resilience” is a sacred word that means “resistance” . . . resisting bad thoughts, bad behaviors. We accept what life gives us, good and bad, as gifts from the Creator. We try to get through hard times, stressful times, with a good heart. The gift [of adversity] is the lesson we learn from overcoming it.

Clairmont’s description of “the sacred word that means resilience” are strikingly similar to several contemporary ideas in counseling and psychotherapy practice.

  • “Resisting bad thoughts, bad behaviors” is closely linked to CBT
  • “We accept what life gives us, good and bad, as gifts from the Creator” fits well with mindfulness
  • “We try to get through hard times, stressful times, with a good heart” is consistent with optimism concepts in positive psychology
  • “The gift [of adversity] is the lesson we learn from overcoming it” and this is a great paraphrase of Bandura’s feedback and feed-forward ideas

In these days of cultural specificity, it makes sense to work from both perspectives. We need to recognize and value our unique differences, while simultaneously noticing our similarities and areas of convergence. Clairmont’s perspectives on resilience make me want to learn more about Lakota ideas, both how they’re similar and different from my own cultural and educational experiences.

Working in the Cognitive Dimension

Today I’ve been putting together my powerpoints for the upcoming Nate Chute Foundation workshop. The NCF workshop is on two consecutive Tuesday evenings, starting this coming Tuesday.

While reviewing content for the ppts, I tried to pull all the intervention strategies from my brain, and failed. My excuse is that there are too many possible interventions for my small brain to memorize. As a consequence, I was forced to check out the “Practitioner Guidance and Key Points to Remember” sections at the end of all the intervention chapters. To give you a taste, here’s a photo of the “summary” page at the end of the cognitive chapter.

The Cognitive Dimension – Chapter Summary

Each of these bulleted items represents a potential method or strategy for intervening in the cognitive dimension with clients or students who are experiencing suicidality. I’m looking forward to talking about these strategies at the Nate Chute workshop, but rather than trying to commit them to memory (like Ebbinghaus would have), I’ll be using my powerpoint slides as a memory aid.

I hope you’re all having a great Sunday night.

John SF

Talking with Clients about Previous Suicide Attempts from a Strengths-Based Perspective

Working with suicidal clients often involves working two sides at the same time. . . as in a dialectic or paradox. For example, it’s crucial to be able to move back and forth between empathic acceptance and active-collaborative problem-solving.

When working from a strengths-based model, clinicians shouldn’t shy away from focusing on pain, sadness, anger, or other aversive emotions and experiences. At the same time, we need to also focus on potential strengths. The following excerpt from our new suicide book illustrates how to explore previous attempts, while also looking for strengths.

Previous Attempts

Previous attempts are often considered the most significant suicide predictor (Brown et al., 2020; Fowler, 2012). You can gather information about previous attempts through your client’s medical or mental health records, from an intake form, or during the clinical interview. During clinical interviews, clients may spontaneously tell you about previous attempts; other times you’ll need to ask directly. Again, using a normalizing frame can be facilitative:

It’s not unusual for people who are feeling very down to have made a suicide attempt. I’m wondering if there have been times when you were so down that you tried to kill yourself?

Once you have knowledge about a client’s previous suicide attempt, you can explore several dimensions of the attempt:

  • What was happening that made you want to end your life?
  • When you discovered that your suicide attempt failed, what thoughts and feelings did you experience?
  • Some people report learning something important from attempting suicide. Did you learn anything important? If so, what did you learn?

Although the preceding questions are important for assessment, once you’re ready to move beyond exploration of a previous attempt, you should ask a therapeutic solution-focused question, similar to the following:

You’ve tried suicide before, but you’re here with me now . . . what has helped? (Sommers-Flanagan & Sommers-Flanagan, 2017, p. 373).

Asking “What helped?” is central to a strength-based or solution-focused model and sometimes illuminates a path forward toward living. However, if your client is depressed, you may hear,

Nothing helped. Nothing ever helps (Sommers-Flanagan & Sommers-Flanagan, 2017, p. 373).

In the context of an assessment protocol, the “What helped?” question and its side-kick, “What have you tried?” are important because they assess for two core cognitive problems associated with suicidality: hopelessness and problem-solving impairment. Clients who respond with “nothing ever helps” are communicating hopelessness. Clients who claim, “I’ve tried everything” or “There’s nothing left to do” are communicating hopelessness, plus the narrowing of cognitive problem-solving that Shneidman (1996) called mental constriction. Hopelessness and problem-solving impairments should be integrated into your suicide treatment plan.

You can read more excerpts of our book in other posts on this blog, via Amazon or Google. You can also purchase it as an eBook through Wiley, Amazon, or as a paperback through the American Counseling Association: https://imis.counseling.org/store/detail.aspx?id=78174

Free Wiley-Sponsored Webinar

Hi All,

On March 3, the publisher, John Wiley & Sons is offering a free day-long webinar. They’re calling it a “Psychology Thought Leadership Summit.”

Full disclosure, I’m presenting at the 2:30pm-3:15pm (Eastern) time-slot. My presentation is titled: “Interviewing for Happiness: How to Weave Positive Psychology Magic Into the Interview Process.” Here’s my presentation description:

Freud once said that “words were originally magic.” In this interactive presentation, John Sommers-Flanagan will describe how clinical interviewing involves a process of using word magic to shift clients from a locked constructivist state to receptive social constructionism. This presentation focuses on systematically integrating positive psychology (aka happiness interventions) into a standard initial clinical interview protocol. Intentionally and systematically weaving happiness interventions into initial interviews is especially important because many people are being adversely affected by social isolation and challenges associated with the global pandemic.

Some of the other presenters are very notable. For example, Derald Wing Sue is presenting “Microintervention Strategies: Disarming Individual and Systemic Racism and Bias” during the at the 9:45am to 10:45am (Eastern) time slot. Here’s Dr. Sue’s presentation description:

Microinterventions are the everyday words or deeds—whether intentional or unintentional—that communicate the following concepts to targets of microaggressions: 

  • Validation of their experiential reality
  • Value as a person
  • Affirmation of their racial or group identity
  • Support and encouragement
  • Reassurance that they are not alone 

More importantly, they serve to enhance psychological well-being, and provide targets, allies, and bystanders with a sense of control and self-efficacy. 

This session provides participants with the opportunity to learn, practice, and rehearse microintervention strategies and tactics to disarm and neutralize expressions of bias by perpetrators while maintaining a respectful relationship. 

To check out all the specific webinar events throughout the day, click here.

In the following paragraph I’ve pasted the Wiley promo, which includes a link to sign yourself up. . . or just REGISTER HERE. It looks like you’re supposed to register very soon, so check it out.

Wiley     Wiley Psychology Thought Leadership Summit

March 3, 2021            

As one of the world’s leading psychology publishers, Wiley offers trusted and vital resources written by leading subject matter experts in the field.   Join colleagues from across North America for the Wiley Psychology Thought Leadership Summit featuring some of our top authors. Speakers will give inspiring talks and conduct breakout sessions where you’ll gain insight and ideas to bring back to your classroom or practice.   Choose from multiple sessions on March 3, 2021.     Sign Me Up