Earlier this week I found a parallel universe wherein I was able to convince three people that it would be terribly fun to sit with me in a classroom for 2+ hours and work through the post-course data from our most recent “Happiness for Educators” class. This involved me figuring out how to screencast my computer onto a big screen where I went through the process of accessing our Qualtrics file and exporting the data to SPSS. Then, while experiencing intermittent fits of joy, we cleaned the data, used the “recode” function to reverse score all the items requiring reverse scoring and then calculated our 16 different outcome variables.
In this parallel universe, the three people who joined me (you know who you are), asked great questions and acted interested the WHOLE time. Of course, one of the “people” is a well-established Missoula actor, so there’s the possibility that I was fooled by some excellent acting or feigning or pretending. That said, finding a parallel universe where people act interested in stats remains a feat to brag about.
We made it through all the post-test data. To maximize the fun and bring us all to a place of breathless excitement, I ran a quick descriptive analysis. At first glance, the data looked okay, but not great. Of course, we didn’t have the pretest outcome variables analyzed, and so we were forced to leave with bated breath.
Today, access to the parallel universe was briefly adversely affected by a slight temporal shift; nevertheless, I found one of the “people” and she enthusiastically embraced another 2 hours of stats. . . . At the end, she shouted from her office, “That was fun!”
I know at this point, I am, as Freud might say, “straining your credulity” but I speak the whole truth and nothing but the truth.
And the rest of the truth gets even better. Tammy (my new best stats friend) and I found the following statistical results.
89 of 100 students completed the pre-post questionnaires.
We had statistical significance on ALL 16 outcomes—at the p < .01 level (or better).
The effect sizes (Cohen’s d with Hedges adjustments) were among our best ever, with top outcomes being:
Improved positive affect (feeling more cheerful, etc): d = .900 (a LARGE effect size)
Reduced negative affect (feeling fewer negative emotional states) d = 885. (a LARGE effect size)
Improved total self-reported physical health (a compilation of better sleep, reduced headaches, reduced gastrointestinal symptoms, fewer respiratory symptoms) d = .821 (a LARGE effect size)
Reduced depression (as measured by the CES-D): d = .732 (an almost LARGE effect size)
If you’re reading this, I hope you’re skeptical. Because if you’re skeptical, then I’m sure you’ll want to know whether this is the first, second, third, or fourth time we’ve found this pattern of results. Nope. It’s the FIFTH consecutive time we’ve had all significant outcomes or nearly all significant outcomes that appear to be happening as a function of our happiness for educators course.
Although I am in constant fear that, next time, the results will be less impressive, I’m getting to the point where I’m thinking: These results are not random error, because we now have data across five cohorts and 267 teachers.
If you’re reading this, I also hope you’re thinking what I’m thinking. That is: You should take this course (if you’re a Montana educator) or you should tell your Montana educator friends to take this course. If you happen to be thinking what I’m thinking, here’s the link to sign up for our summer sections.
Last Friday night (or Saturday morning in South Korea), I had the honor and privilege of spending three hours online with 45 South Korean therapists. We were talking, of course, about strengths-based suicide assessment and treatment. Given my limited Korean language skills (is it accurate to say my language skills are limited if I can’t say or comprehend ANYTHING in Korean?), I had a translator. Although I couldn’t tell anything about the translation accuracy, my distinct impression was that she was absolutely amazing.
I had a friend ask how I happened to get invited to present to Korean therapists. My main response is that I believe the time is right (aka Zeitgeist) for greater integration of the strengths-based approach into traditional suicide assessment and treatment. The person who recruited me was Dr. Julia Park, another absolutely amazing, kind, and competent South Korean person, who also happens to hold an Adlerian theoretical orientation. Thanks Julia!
Just for fun, I wish I had my Korean translated ppts to share here. They’re unavailable, and so instead I’m sharing an excerpt from Chapter 10 (Suicide Assessment Interviewing) of our Clinical Interviewing (2024) textbook. The section I’m featuring is the part where we review issues and procedures around suicide risk categorization and decision-making.
You may already know that some of the latest thinking on suicide risk assessment is that we should not use instruments like the Columbia to categorize risk. You also may know that not only am I a believer in this latest thinking, I can be wildly critical of efforts to categorize suicide risk. . . so much so that I often end up using profanity in my professional presentations. Of course, because the context is a professional presentation, I only use the highly professional versions of profanity.
Here’s a LinkedIn comment about that issue from Craig Bryan. Dr. Bryan is a suicide researcher, professor at The Ohio State University, and author of “Rethinking Suicide.” In support of him and his research and thinking, I’d like to professionally say that although I lean away from reductionistic categorization of things, all signs point to the likelihood that Dr. Bryan has a very large brain.
The good news is that I feel validated by Dr. Bryan’s strong comments against categorizing suicide risk. But the bad news is that we all live in the real world and in the real world sometimes professionals have to do more than just swear about risk categorization—we have to actually make recommendations for or against hospitalization, consult with other professionals who want our opinion, and quoting me as saying that risk factor categorization is pure bullshit may not be the best and most professional option.
So . . . what are we to do? First, we parse Dr. Bryan’s comments. He’s not saying NEVER categorize risk or make risk estimates. He’s saying don’t categorize “negative screens as low risk” which is slightly different than don’t try to estimate risk. His message is that we have too many false negatives—where someone screens negative and then dies by suicide. In other words, we should not be confident and say negative screens are “low risk.” That’s different from throwing the baby out with the bathwater.
It might be easy to think that Dr. Bryan’s comments are discouraging. But I view him as just saying we should be careful professionals. To help with that, below is the excerpt on Suicide risk categorization and decision-making, from our textbook. If you’re in a situation where you have to make a professional recommendation about suicide risk, this information may be helpful. BTW, the reason I was inspired to post this excerpt is because the Korean participants were wonderful and asked lots of hard questions, including questions related to this topic.
Suicide Risk Categorization and Decision-Making
Throughout this chapter, we have acknowledged the limits of categorizing clients on the basis of risk. The current state of the science indicates that efforts to predict client suicides (i.e., categorize risk) are likely to fail. Nevertheless, when necessary—because of institutional requirements or client inability to collaborate on safety or treatment planning—all clinicians should be able to use their judgment to estimate risk and make disposition decisions for the welfare of the client. As a consequence, we review a suicide risk categorization and decision-making model next.
Consultation
Consultation with peers and supervisors serves a dual purpose. First, it provides professional support; dealing with suicidal clients is difficult and stressful; input from other professionals is helpful. For your health and sanity, you shouldn’t do work with suicidal clients in isolation.
Second, consultation provides feedback about appropriate practice standards. Should you need to defend your actions and choices following a suicide death, you’ll be able to show you were meeting professional standards. Consultation is one way to monitor, evaluate, and upgrade your professional competency.
Suicide Risk Assessment: An Overview
We reviewed an overwhelming number of suicide risk and protective factors earlier in this chapter. Generally, more risk factors equate to more risk. However, some risk factors are particularly salient. These include:
Previous attempts
A previous attempt is sometimes viewed as suicide rehearsal. Two previous attempts are especially predictive of suicide because they represent repeated intent. Also, when previous attempts were severe and the client was disappointed not to die, risk is high.
Command hallucinations
When clients are experiencing a psychotic state accompanied by command hallucinations (e.g., a voice that says, “You must die’), risk is at an emergency level.
Severe depression with extreme agitation
The combination of depression and agitation can be especially lethal. Agitation can take the form of extreme anxiety or extreme anger.
Protective factors
A single protective factor may outweigh many risk factors. But, it’s impossible to know the power of any individual protective factors without an in-depth discussion with your client. Engagement in therapy and collaboration on a safety plan (and the hope these behaviors signal) can substantially reduce risk.
Nature of Suicidal ideation
As discussed earlier, suicidal ideation is evaluated based on frequency, triggers, intensity, duration, and termination. Some clients live chronically with high suicidal ideation frequency, intensity, and duration—and are low risk. However, if ideation is frequent and intense and accompanied by intent and planning, risk is high.
Suicide Intent
Suicide intent is the factor most likely to move clients toward lethal attempts. Intent can be based on objective or subjective signs. Objective signs of intent include one (or more) previous lethal attempt(s). Subjective signs of intent can include a client rating of intent or client report of a highly lethal plan.
Clinical Presentation
How clients present themselves during sessions is revealing. Clients can be palpably hopeless, talk desperately about feelings of being trapped, and express painful and unremitting self-hatred or shame. But if clients have adapted to these experiences, they may not have accompanying intent and active planning. Observations of how clients talk about their psychological distress will contribute to your final decisions.
Final Decisions
Using a traditional assessment approach, you can estimate your client’s suicide risk as fitting into one of three categories:
Minimal to Mild: Client reports no suicidal thoughts or impulses. Client distress is minimal. Plan: Monitor client distress. If distress rises, or depressive symptoms emerge, re-assess for suicidality.
Moderate to High: Client reports suicidal ideation. As client distress, planning, risk factors, and intent increase, risk increases. Plan: Manage the situation with a collaborative safety plan. Depending on client preference, engaging family or friends as support may be advisable. Make sure firearms and lethal means are safely stored.
High to Extreme: Client reports suicidal ideation, plans, multiple risk factors (likely including a previous attempt), intent, and has access to lethal means. Engagement in treatment is minimal to non-existent. Plan: Treatment may include hospitalization and/or intensive outpatient therapy with a safety plan implemented in collaboration with family/friends. Make sure firearms and lethal means are safely stored.
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As always, please share your thoughts in the comments on this blog.
At long last, we’ve begun work on revising our Counseling and Psychotherapy Theories text for its 4th edition. Over the past several weeks, I’ve been putting in an hour or two a day, chipping away on chapter revisions, reaching out to reviewers, and planning with our new and very exciting co-author, Dr. Bryan Cochran, a highly esteemed psychology professor at the University of Montana. If you’re reading this, I want you to know of Bryan’s awesomeness (and if you’re Bryan, I want you to feel the pressure of this public announcement of your awesomeness) [hahahaha!]
You all probably know that our Theories textbook is far and away the Theories textbook with the most hilarity. No doubt, this is a rather low bar, given that I can’t find any funny stories in any other theories texts. We view theories hilarity to be extremely important in a theories text, because reading many theories texts can parallel the proverbial experience of watching paint dry.
Bryan’s addition to the writing team will give us something we need—an expert in the LGBTQ+ domain, and someone with a talent for telling stories that are simultaneously engaging, informative, and fun to read. Right now, he’s busy writing a “Lenses” chapter (to be Chapter 2) to orient readers to important theory-related lenses like (a) Queer theory, (b) Critical Race theory, (c) Intersectionality, and more. I, for one, can hardly wait for his Queer theory quips.
News Flash: In the past, I’ve put out broad calls for chapter reviewers. This time, I’m being selective and directly asking prominent theories experts to review chapters and offer guidance. Some examples: For the Adlerian chapter we’ve got Marina Bluvshtein (woohoo!) and Jon Sperry (wow!). For the Psychoanalytic chapter, we got Nancy McWilliams (amazing!) and Pratyusha Tammala-Narra (fantastic!).
If you happen to be a specific theories subject matter expert, you should email me at john.sf@mso.umt.edu to get in on the fun. Or if you have a prominent theories friend/colleague to recommend, have them email me.
As one last theories teaser, below I’m pasting a few excerpts from Nancy McWilliams’s 2021 article titled, “Diagnosis and Its Discontents: Reflections on Our Current Dilemma.” I love this article as it gives a glimpse into problems with contemporary diagnoses and how psychodynamic therapists use individualized assessment in ways to honor the real-life complexities clients bring into psychotherapy. The excerpts below are from her article, which is linked at the end of this post.
On Labeling
The idea that one is anxious (or depressed or obsessive) about something that has meaning is being lost. Fitting an individual into a category tends to foreclose exploration of what is unique to a patient; it especially prevents insights into unexpected aspects of a person’s psychology or exploration of areas that are felt as shameful – the very areas that are of particular value in planning and carrying out psychotherapy.
On the vexing ways in which patients think about themselves and their diagnoses
It used to be that a socially avoidant woman would come for therapy saying something like, “I’m a painfully shy person, and I need help learning how to deal better with people in social situations.” Now a person with that concern is likely to tell me that she “has” social phobia – as if an alien affliction has invaded her otherwise problem-free subjective life. People talk about themselves in acronyms oddly dissociated from their lived experience: “my OCD,” “my eating disorder,” “my bipolar.” There is an odd estrangement from one’s sense of an agentic self, including one’s own behavior, body, emotional and spiritual life, and felt suffering, and consequently one’s possibilities for solving a problem. There is a passive quality in many individuals currently seeking therapy, as if they feel that the prototype for making an internal psychological change is to describe their symptoms to an expert and wait to be told what medicine to take, what exercises to do, or what self-help manual to read.
On “chemical imbalances”
. . . viewing psychological suffering as a set of disorders that can be fixed or improved chemically can easily invite the obverse assumption that those painful experiences are ultimately caused by random or genetically based chemical differences among individuals. This is a false conclusion, of course, something like saying that because marijuana improves appetite, the cause of low appetite is lack of marijuana. But it is nevertheless a frequent leap of illogic – in the thinking of nonprofessionals and of some professionals as well – to ascribe much severe psychological suffering to a “chemical imbalance.” Such a construction tempts us to ignore all the painful other sources of psychological suffering, such as poverty, neglect, trauma, and the myriad ways in which human beings can injure each other psychologically.
On not overgeneralizing research findings/recommendations to unique patients
. . . consider patients at the extreme end of the obsessive-compulsive continuum, whose obsessions border on delusional beliefs, who suffer profound annihilation anxiety, who wholeheartedly believe they will die if they fail to carry out their rituals, and who regard the therapist with suspicion for not sharing their conviction – in other words, the subgroup of obsessive patients that Kernberg (1984) would consider as psychologically organized at the low borderline or psychotic level. My experience suggests that with this group exposure therapy not only fails, it demoralizes the patients, makes them feel like failures personally, and kills any hope they may have that psychotherapy can help. It also demoralizes therapists, who have been told again and again that exposure therapy is the treatment of choice for OCD. If they believe their teachers, such clinicians can easily conclude they are simply not good enough therapists.
If I’ve piqued your interest in “Diagnosis and its discontents” by Nancy McWilliams, here’s a pdf of the article.
Last week was a blur. On Wednesday, I did a break-out session for the Montana Prevent Child Abuse and Neglect conference in Helena. I’ve been to this conference multiple times and always deeply appreciate the amazing people in Montana and beyond who are dedicated to the mission of preventing child abuse and neglect. For the break-out, I presented on “Ten Things Everyone Should Know About Mental Health, Suicide, and Happiness.” This is one of my favorite newish topics and I felt very engaged with the 120+ participants. A big thanks to them.
Before the session, I felt a bit physically “off.” Overnight, the “off” symptoms developed into a sore throat and cough. This would NOT have been a problem, except I was scheduled for the hour-long closing conference keynote on Thursday. The good news is that I had zero fever and it was NOT Covid. The bad news was my voice was NOT good. I did the talk “In Pursuit of Eudaimonia” with 340ish attendees and got through it, but only with the assistance of a hot mic.
I had to cancel my Friday in Missoula and ended up in Urgent Care, with a diagnosis of bronchitis or possibly pneumonia, which was rather unpleasant over the weekend.
Having recovered (mostly), by yesterday, I recorded a podcast (Justin Angle’s “A New Angle” on Montana Public Radio) at the University of Montana College of Business. Thanks to a helpful pharmaceutical consult with a helpful woman at Albertsons, I had just the right amount of expectorant, later combined with a strong cough suppressant, to make it through 90 minutes of fun conversation with Justin without coughing into the podcast microphone. We talked about “Good Faith” in politics, society, and relationships. The episode will air in early June.
And now . . . I’m in beautiful Butte, Montana, where I’m doing an all-day (Thursday) workshop for the Montana Sex Offender Treatment Association. . . on Strengths-Based Suicide Assessment and Treatment . . . at the Copper King Hotel and Convention Center. Not surprisingly, having slept a bit extra the past five days, I’m up and wide awake at 4:30am, with not much to do other than post a pdf of my ppts for the day. Here they are:
Thanks for reading and thanks for being the sort of people who are, no doubt, doing what you can to make Montana and the world a little kinder and more compassionate place to exist.
I’ve spent the better part of the past two weeks doing presentations in various locations and venues. I did five presentations in Nebraska, and found myself surprisingly fond of Lincoln and Kearney Nebraska. On Thursday I was at a Wellness “Reason to Live” conference with CSKT Tribal Services at Kwataqnuk in Polson. Just now I finished an online talk with the Tex-Chip program. One common topic among these talks was the title of this blog post. I have found myself interestingly passionate about the content of this particular. . . so much so that I actually feel energized–rather than depleted–after talking for two hours.
Not surprisingly, I’ve had amazingly positive experiences throughout these talks. All the participants have been engaged, interesting, and working hard to be the best people they can be. Beginning with the Mourning Hope’s annual breakfast fundraiser, extending into my time with Union Bank employees, and then being with the wonderful indigenous people in Polson, and finally the past two hours Zooming with counseling students in Texas . . . I have felt hope and inspiration for the good things people are doing despite the challenges they face in the current socio-political environment.
If you were at one of these talks (or are reading this post), thanks for being you, and thanks for contributing your unique gifts to the world.
For your viewing pleasure, the ppts for this talk are linked here.
Today, Dr. Bossypants (aka Rita) offered me a coauthor opportunity. Thanks Dr. BP!
Problems, like trees, have roots. As Alfred Adler (and many others) would have said, problems are multi-determined, meaning: There’s always more than one root. Most of us agree that the United States has big problems. But what are the roots of our troubles?
One side insists that the roots of our troubles include unworthy and illegal immigrants, burdening the rich with taxes, satanic trans folk, welfare fakers, and bleeding hearts. The media picks up this messaging, repeating these highly questionable theories until they sink into our psyches as if they were true.
But we are being played.
As they said back in the Watergate era, follow the money.
The rare transgender athlete is not to blame for your low wages or the price of food and shelter. Tending to the disabled and disadvantaged is not breaking the bank. Social Security makes us a strong, compassionate society—providing for all of us as we age. Social Security isn’t going broke. It’s being dismantled and privatized so the wealthy benefit.
We’re chopping off our noses to spite our faces. USAID greatly contributed to the health of the poor, the planet, and developing societies trying to recover, survive, and grow. NPR and PBS cost about $1.50 per person per year. Although their coverage has been leaning right, they work toward being objective, balanced, and accurate. A free press is at the heart of democracy.
Hiding the contributions of people of color from American history involves rewriting reality. What might be the purpose of excluding honorable actions and voices of diverse individuals and groups from our history? There’s an African proverb: “Until lions have their historians, tales of the hunt shall always glorify the hunter.” Preserving real history doesn’t make us less safe. Massive salaries, bonuses, and advantages given to those mismanaging and/or dismantling our social and financial safety nets is a real danger.
Billionaires have lied so well for so long that many Americans blame poor people and the middle class for government waste and fraud. As everyone admits, government waste and fraud exist, and there are effective strategies for minimizing waste and fraud. One billionaire strategy is this: Get the American people to blame each other for their financial woes. Then, through their tax loopholes, billionaires walk right into the henhouse and steal the country’s eggs.
Most billionaires don’t become billionaires because of their compassion and generosity. They’re billionaires because of miners, farmers, mill workers, steelmakers, refinery workers, teachers, servers, nurses, doctors, social workers, inventors, and small businesspeople: THESE are the people who make becoming a billionaire possible.
Balanced budgets are possible. Giving billionaires MORE money will not balance the budget. Taxing them more will. A graduated income tax is not the same thing as socialism. Anyone who tells you that taxing the rich and providing a social safety net is socialism or communism either (a) wants YOUR money, (b) is lying, or (c) is ignorant.
Socialism is a political and economic theory advocating that the means of production, distribution of goods, and trade/exchange be owned by the collective. Taxing the wealthy in a proportionate manner is not the same as having the collective or the government take over ownership of their businesses. In a capitalist system, taxes and government regulation function to reduce power imbalance, abuse of the poor by the wealthy, and the development of social safety nets and public health systems that benefit the whole.
The ugly fights we’re in now were started purposefully and fueled by lies, phony moral outrage, purchased bots and paid “news” outlets. We’ve been duped into “culture wars.” As if a gay marriage is why you aren’t paid fairly. As if God needs guns to defend holiness. As if basic health care for everyone will cost more than our broken system. As if we cannot share bathrooms. We share bathrooms all the time in our homes, while camping, at outdoor sporting events (think porta potties). Our economic and social problems are NOT ABOUT BATHROOMS.
We would say “wake up,” but the billionaires have cleverly stolen that concept. They want us asleep. They want us less educated, less compassionate, and more frightened.
Those in power twist science, scripture, economics, virtue, common sense, and the idea of community. But they can’t take your soul; they can’t eliminate your deep awareness of right and wrong. Only you can do that.
Ask yourselves:
If climate change caused by humans is wrong, why not clean things up anyway? Powerful people can say “drill baby drill” and it sounds aggressively American, but really, who’s pro-pollution? Denying climate change will cost us our planet.
All religions, including Christianity, advocate for taking care of the poor. Yes, it costs a few shekels. But do we want the alternative? Shall we harden our hearts and let others suffer and die?
If you believe YOU should have control over your own body and your own sexual decisions, maybe YOU can let others own their bodies and make their own choices as well?
Science is not a simplistic fact-finding mission. Science is a disciplined process of inquiry. Scientific knowledge has saved millions of lives. Funding science is about progress and having a higher quality of living. Superstition, politicizing, and irrational attacks on science is regressive, ignorant, and dangerous.
Do you think the Creator expects YOU to force your version of morality onto others? Should you enforce thou shalt not kill with weapons? Aren’t you busy enough just finding the time and resources to love your neighbor? Care for the poor? Offer your coat to anyone who needs it? It takes a lifetime to remove the log in your eye, so you can see well enough to help someone with a splinter? Isn’t God, by definition, omnipotent? We should all stop confusing our will, our interests, and our greed, with God’s will.
We need the rule of law. When people in power disregard and disparage the courts, they’re not acting for the common good. If we lose the rule of law, we’ll be ruled by outlaws.
Over our long history, humans have been conned, cheated, manipulated, and enslaved many times by the rich, powerful, and depraved. Trusting billionaires and others who are energized by the pursuit of power, greed, and revenge does not end well.
This past week I had the honor and privilege of offering four presentations, one each on Monday, Tuesday, Wednesday, and Thursday.
Monday was a Zoom date with a counseling class at West Virginia University.
Tuesday was an exciting in-person presentation for the University of Montana MOLLI program, kicking off our small group experiential Evidence-Based Happiness course for older adults. It was phenomenal. The older adults always bring it. One–among many–highlights was an 88 -year-old guy who, in the midst of the Three-Step Emotional Change Trick, shared about how he “Honored” his emotions by joining a grief group after his wife died (3 years ago). His sharing was beautiful and perfect.
Wednesday was my annual visit to Dr. Timothy Nichols’s Honors College course on LOVE. Dr. Nichols happens to be the Dean of the Honors College and one of the coolest and kindest and most enthused people on the planet. Mostly I go every year just to hear him introduce me. In truth, I also go because the topic and the students are INCREDIBLE. I think it may have been the best LOVE lecture EVER. I’d post the ppts here, but my computer crashed yesterday, and the U of M IT people (who are always very nice) are now attempting “data recovery.” Argh!
Thursday I got to hang out for two hours with the Graduate Students of the University of Montana Psychology Club. This was yet another fun experience with a group of students who are all simply brilliant. To top it off, a couple of my favorite people (and Psych faculty), Bryan Cochran and Greg Machek also attended. . . providing the precise level of sarcasm and humor that made the experience practically perfect. Here are the Psych Club’s ppts, which I happened to have on a flash drive:
I’ve been in repeated conversations with numerous concerned people about the risks and benefits of suicide screenings for youth in schools. Several years ago, I was in a one-on-one coffee shop discussion of suicide prevention with a local suicide prevention coordinator. She said, more as a statement than a question, “Who could be against school-based depression and suicide screenings?”
I slowly raised my hand, forced a smile, and confessed my position.
The question of how and why I’m not in favor of school-based mental health and suicide screenings is a complex one. On occasion, screenings will work, students at high-risk will be identified, and tragedy is averted. That’s obviously a great outcome. But I believe the mental health casualties from broad, school-based screenings tend to outweigh the benefits. Here’s why.
Early identification of depression and suicide in youth will result in early labeling in school systems; even worse, young people will begin labeling themselves as being “ill” or “defective.” Those labels are sticky and won’t support positive outcomes.
Most youth who experience depressive symptoms and suicide ideation are NOT likely to die by suicide. Odds are that students who don’t report suicidal ideation are just as likely to die by suicide. As the scientists put it, suicidal ideation is not a good predictor of suicide. Also, depression symptoms generally come and go among teenagers. Most teens will recover from depressive symptoms without intensive interventions.
After a year or two of school-based screenings, the students will know the drill. They will realize that if they endorse depression symptoms and suicidal items that they’ll have to experience a pretty horrible assessment and referral process. When I talk to school personnel, they tell me that, (a) they already know the students who are struggling, and (b) in year 2 of screenings, the rates of depression and suicidality plummet—because students are smart and they want to avoid the consequences of being open about their emotional state.
About 10-15% of people who complete suicide screenings feel worse afterward. We don’t really want that outcome.
There’s no evidence that school-based screenings are linked to reductions in suicide rates.
For more info on this, you can check out a brief commentary I published in the American Psychologist with my University of Montana colleague, Maegan Rides At The Door. The commentary focuses on suicide assessment with youth of color, but our points work for all youth. And, citations supporting our perspective are included.
Here are a few excerpts from the commentary:
Standardized questionnaires, although well-intended and sometimes helpful, can be emotionally activating and their use is not without risk (Bryan, 2022; de Beurs et al., 2016).
In their most recent recommendations, the United States Preventive Services Task Force (2022) concluded that the evidence supporting screening for suicide risk among children and adolescents was “insufficient” (p. 1534). Even screening proponents acknowledge, “There is currently little to no data to show that screening decreases suicide attempt or death rates” (Cwik et al., 2020, p. 255). . . . Across settings, little to no empirical evidence indicates that screening assessments provide accurate, predictive, or useful information for categorizing risk (Bryan, 2022).
This post is a continuation of my focus on kindness, positive psychology, and becoming the best possible versions of ourselves. Lyrics from Katharine Lee Bates’s America the Beautiful are part of my underlying inspiration. Buried in the 3rd verse, she wrote, “Till all success be nobleness.” We all should be seeking to be our best and noblest selves, but there are forces in the world pulling in less noble directions. Be forewarned that this post can be interpreted politically or through an historic religious lens. That’s not my intent. The point is simply that we should resist darker impulses and join together to elevate virtuous well-being for as many of us as we can muster. (Here’s Keb Mo singing my favorite version of “America the Beautiful” https://www.youtube.com/watch?v=zcUx3I0k_Fw):
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In 2015, at a family dinner, I told my sister that if then-candidate Donald Trump were caught in a strong headwind, his hair would fly up, revealing the number 666 (the mark of the Beast) on his forehead. My sister said, “John, you’re being overly dramatic.” She was right.
And so was I.
So many scenes and statements over the past month have been nauseating and shameful. When Trump, along with his #1 sycophant, JD Vance, berated Ukrainian President Volodymyr Zelenskyy (the only courageous person in the room), it was like a bad episode of an already failing reality television show. Trump likes to use the word disgrace to describe his adversaries. Trump was, is, and always will be a disgrace. As with most of his insults, “disgrace” is a projection that he pulls out of his own psyche and pastes onto others.
Musk and Trump are firing civil servants and dismantling government services. They have no concern for the lives of people they are destroying. One of their first targets was USAID. Why? Because USAID does kind, generous, and nice things for people across the globe who are in need and suffering. USAID does not promote crypto or cater to the well-heeled. For Musk and Trump, the suffering of others is sometimes collateral damage; other times being cruel is their point.
My new measure for politicians and other humans is kindness. USAID was doing more kind, generous, and compassionate things in one day, than Musk and Trump have done in their combined lifetimes. Marco Rubio recently announced that over 80% of USAID programming is cut. This is not a noble path.
If you don’t believe me, that’s fine. Do the research. Check it out. But don’t believe them. Mega-wealthy people who tell you they’re looking out for your best interests are nearly always lying. Trump and Musk didn’t get rich off their compassion; they got rich using, abusing, and scamming others.
My list of republican sycophants is long and boring. I’m thinking of Lindsey Graham and Rubio, but there are so many others. Most republicans don’t have Zelenskyy’s courage, so they insult him, or imply that he didn’t read the room. Seriously? He read the room with precision. His first option was to get screwed by Trump and Vance while acting like their lap dog. His second option was to stand strong in the face of their theatrical insults to fight for his country and his people. He chose the latter. There never was an option that was in Ukraine’s best interests. The situation was a set up; Zelenskyy took the only respectable option.
Many republicans recognize our democracy is at stake, but they cave to Trumpian bullying anyway. Spineless, led by their fear, they capitulate, even when they know that unpredictable tariffs are reaping chaos on the economy. They capitulate even when they know that pardoning January 6 rioters who attacked the police is wrong. They remain quiet and demur while a legal protester and recent graduate from Columbia University is arrested.
I’m in a fevered state. I may regret putting my thoughts into words, but what I’m saying is coming directly from the burning in my heart for noble causes. I love America. I love the goals and hard work of organizations like USAID. I love civil servants. I stand with them, with Zelenskyy, with peaceful protesters, with the Department of Education, to push back against the big gangsters in their big, imaginary thrones.
If Evil had a plan, it might be this: Make the tired, hungry, and poor the enemy. Sow fear and distrust; grow it into jealousy and hate. Once the hate sprouts, attack the poor and disenfranchised. Cut federal education because of its great value to the poor and uselessness to the rich. Eliminate environmental protections for marginalized communities; let them breathe monoxide and drink brown water because their voices are easy to ignore or dismiss. Destroy USAID, because what wealthy person ever benefited from aid to the hungry or medicines for the sick? Convince the gullible to distrust medicine and question life-saving vaccines; only the affluent deserve to live long and healthy lives.
If Evil had a plan, it might be happening—even as you read these words. And the plan is profoundly Un-American.
But Evil is not a thing or a person. Evil, and all things we call Evil, are conceptual. The great Evil makes us all fall from grace. Evil plays the news cycle, promotes hate, stokes division, and makes us all less good, less happy, angrier, and less compassionate. I was wrong in 2015. If you look closely at Donald Trump’s forehead, you won’t see the numbers 666. He’s no concrete embodiment of Evil. Instead, if you look and listen closely, you’ll see and hear a large vacuous ego that seeks to fill itself with power, and by inspiring everyone to hate more and be less humane, because, quite frankly, that’s how “Evil” works.
Now is the time to put Evil in the rear-view mirror. We will need all our combined strength to make this happen. We need to reach out in kindness and compassion. We need to push back against messages of hate and division and policies that further decimate the poor and disenfranchised. We need to listen to the small, still voice in the night, the voice that knows our name, the voice beckoning us to embrace our better selves and noble natures.
This week I had a chance to do a couple presentations for a couple awesome groups.
On Monday, along with Victor Yapuncich, I presented a talk at Fairmont titled “Why We Should Be in Pursuit of Eudaimonia (Not just “Happiness”)” to the Rural Medical Training Collaborative of the Family Medicine Residency of Western Montana. The group was amazing, and we even got Evelyn and Shilo to sing with us at the end. Here are the ppts for the Fairmont talk:
Today, I had the honor to deliver the closing talk for Tamarack Grief Resource Center’s annual Grief Institute. Thanks Tina . . . for the amazing opportunity. It was fabulous to be with such an incredibly dedicated and compassionate group of professionals who are using their gifts to help people through the journey of grief. Here are the ppts for the Grief Institute:
John Sommers-Flanagan 