Tag Archives: Writing

Clinical Interviewing, Writing

The Definition of a Clinical Interview

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The following excerpt is from our freshly published textbook, Clinical Interviewing (2024, 7th edition, Wiley).

What Is a Clinical Interview?

Clinical interviewing is a flexible procedure that mental health professionals use to initiate treatment. In 1920, Jean Piaget first used the words “clinical” and “interview” together in a way similar to contemporary practitioners. He believed existing psychiatric interviewing procedures were inadequate for studying cognitive development in children, so he invented a “semi-clinical interview.”

Piaget’s approach was novel. His semi-clinical interview combined tightly standardized interview questions with unstandardized or spontaneous questioning to explore the richness of children’s thinking processes (Elkind, 1964; J. Sommers-Flanagan et al., 2015). Interestingly, the tension between these two different interviewing approaches (i.e., standardized vs. spontaneous) continues today. Psychiatrists and research psychologists primarily use structured, or semi-structured clinical interviewing approaches. Structured clinical interviews involve asking the same questions in the same order with every client. Structured interviews are designed to gather reliable and valid assessment data. Virtually all researchers agree that a structured clinical interview is the best approach for collecting reliable and valid assessment data.

In contrast, clinical practitioners, especially those who embrace post-modern and social justice perspectives, generally use less structure. Unstructured clinical interviews involve a subjective and spontaneous relational experience. These less structured relational experiences are typically used to collaboratively initiate an assessment or counseling process. Murphy and Dillon (2015) articulated the latter (less structured) end of the interviewing spectrum:

We believe that clinical interviewing is—or should be—a conversation that occurs in a relationship characterized by respect and mutuality, by immediacy and warm presence, and by emphasis on strengths and potential. Because clinical interviewing is essentially relational, it requires ongoing attention to how things are said and done, as well as to what is said and done. . . . we believe that clinicians need to work in collaboration with clients . . . (p. 4)

Research-oriented psychologists and psychiatrists who value structured clinical interviews for diagnostic purposes would likely view Murphy and Dillon’s description of this “conversation” as a bane to reliable assessment. In contrast, clinical practitioners often view highly structured diagnostic interviewing procedures as too sterile and impersonal. Perhaps what’s most interesting is that despite these substantial conceptual differences—differences that are sometimes punctuated with passion—structured and unstructured approaches represent legitimate methods for conducting clinical interviews. A clinical interview can be structured, unstructured, or a thoughtful combination of both. (See Chapter 11 for a discussion of clinical interviewing structure.)

Formal definitions of the clinical interview emphasize its two primary functions or goals (J. Sommers-Flanagan, 2016; J. Sommers-Flanagan et al., 2020):

  1. Assessment
  2. Helping (including referrals)

To achieve these goals, all clinical interviews involve the development of a therapeutic relationship or working alliance. Optimally, the therapeutic relationship provides leverage for obtaining valid and reliable assessment data and/or providing effective interventions.

With all this background in mind, we define clinical interviewing as…

a complex, multidimensional, and culturally sensitive interpersonal process that occurs between a professional service provider and client. The primary goals are (a) assessment and (b) helping. To achieve these goals, clinicians may emphasize structured diagnostic questioning, spontaneous talking and listening, or both. Clinicians use information obtained in an initial clinical interview to develop a collaborative case formulation and treatment plan.

Given this definition, students often ask: “What’s the difference between a clinical interview and counseling or psychotherapy?” This is an excellent question that deserves a nuanced response. . . . [to be continued]

*************************************

For MUCH more information about the clinical interview, check out the 7th edition of our textbook, creatively titled, Clinical Interviewing. https://www.wiley.com/en-us/Clinical+Interviewing,+7th+Edition-p-9781119981992

Personal Reflections, Politics, Writing

Let’s Stop the Media from Destroying America – Again (Take II)

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I’m into narratives these days, having fallen into the abyss of believing in the social construction of reality. But before you dismiss me as a woo-woo post-modernist, let me say that when I refer to reality, I’m not talking about the molecular composition of the walls in my house. I’m not a magical social constructionist. My walls—and ceilings—are solid realities, regardless of what Richard Bach, my friends, and the media might tell me. When I refer to reality being socially constructed, I’m talking about social reality, mental health labels, the Tooth Fairy, neuro-chemical imbalances, political spin doctoring, and other things people believe in, in the absence of scientific evidence.

My narrative this morning included turning off NPR after less than 60 seconds. Turning off NPR came on the heels of my previous night’s lament of Al Jazeera’s unusually positive coverage of the latest legal indictment of a certain treasonous, lecherous, insurrectionist to whom I will refer to as the former guy (aka TFG), because I’m now refusing to make any further verbal donations to his narrative.

As I lumbered around the kitchen this morning, Rita sarcastically said something like, “You might as well turn on the news to see if NPR is saying anything nice about TFG.” Sadly, within seconds, that’s exactly what we heard. TFG’s voice told us things about, “the indictment” being “totally ridiculous,” and “They’re after you, not me. I’m just standing in the way.”

We never heard a peep about the details of the jeopardy to our national security that TFG has posed and is posing. Neither was there a jot nor a tittle about the nuclear secrets TFG scattered around his various bathrooms, closets, and dining rooms, allegedly making them available to onlookers. We didn’t hear a balanced or fair or representative articulation of the known facts. Nope, we were only provided with socially constructed and obvious lies that as anyone who studies history knows will grow less obvious and more favorable to TFG, the more the local, national, and international news repeat them. . . and repeat them they will.

Seriously, what’s wrong with the media? Why is the media quoting and privileging TFG’s narrative, when his penchant for lying about virtually everything is a known and witnessed fact that requires very little social construction?

Over the years, we’ve given many thousands of dollars to public radio. Today I regret every penny . . . again. The last time I regretted every penny and temporarily stopped giving was back in 2016, when NPR continually let TFG’s voice be front and center over and over on their news broadcasts. All too often I heard his voice on NPR twisting and fabricating reality by saying things like “Crooked Hillary” and “lock her up.” When NPR assigned a nasty conservative woman to cover Hillary’s presidential campaign, big surprise, day after day, she brought up Hillary’s emails, referred to them as a “scandal” and made Hillary sound terrible.

Who writes the news? Who makes decisions to polish up TFG on national news reports, simultaneously flushing the intellectual capacity of the American electorate down the toilet? Who makes the final determination that today and tomorrow and the next day we’ll keep hearing TFG’s voice proclaiming his innocence or using the words witch hunt or insulting his rivals?

Whenever we hear TFGs voice, we’re hearing propaganda. Do you think he’s capable of honesty or of owning up to anything? If you want a review of his personality style and his future behaviors, take a look back at my Slate article from 2018 (https://slate.com/technology/2018/08/no-matter-how-bad-it-gets-trump-will-never-give-up.html). Here’s an excerpt:

We should be ready for a pattern of increasing denial, increasing blame of others, increasing lies, declarations of complete and total innocence, and repeated claims of mistreatment. He will protect and insulate himself from critique and responsibility through active counterattacks, along with alignment, even briefly, with whatever sources of power, control, and dominance he can find. This might mean further alignment with Vladimir Putin, more campaign rallies, and an additional need to gather others around him who will offer only adulation. He will gleefully throw anyone and everyone who betrays him under the bus. As he escalates, his insults toward others will become increasingly demeaning—virtually everyone questioning his superiority will be labeled a dog or disgrace or traitor.

That was from 2018. All this has been predictable, and continues to be predictable.

When I complain privately to NPR, they tell me they work hard to balance the news. Really? Are they balanced because they say so? They can’t be unaware of their misrepresentation of reality through consistent bashing of Biden and over-representation of the voice of TFG. NPR cannot be that obtuse. We need to push them and other news outlets to get it right this time.

We need to hear the news in context. We shouldn’t hear TFG’s voice without also hearing something about the history of his lies, his destruction, his assaulting of women, his defaming whomever he pleases to defame, and the rest of the whole package.

If you want representational, contextual, and historically-informed political news, you should subscribe the Heather Cox Richardson (https://heathercoxrichardson.substack.com/). Or you should check out the fantastic writings of Timothy Snyder, Levin Professor of History at Yale and author of “On Tyranny” (https://timothysnyder.org/). Recently, Snyder wrote:

The job of the executive is to enforce the law. Putting the executive above the law makes nonsense of the Constitution. Does trying a former president make us a banana republic? No, not doing so makes us a banana republic, or really something worse. The moment we say that one person is above the law, we no longer have the rule of law. The moment we no longer have the rule of law, we cease to exist as any kind of republic. . . . In our country, citizens play interesting roles in the judicial branch. For example, they serve on grand juries, such as the one that issued the indictment of Trump on espionage and other charges. This is a process, one to be respected, especially by elected representatives. None of this is political advice.  These are just the words of a citizen who cares about the country.  The political advice, however, would be this: if you commit yourself now to an anti-constitutional position, you will have a hard time extracting yourself later.

Snyder’s words made me think of the news outlets as TFG’s minions. A minion is a follower or underling of a powerful person, especially an unimportant or servile one. Thinking about minions led me to reconstruct Snyder’s words as a message for TFG’s media minions:

If you commit yourself now to an anti-constitutional narrative from TFG, you will have a hard time extracting yourself later.

Write to your news media. Tell them you want representative, contextual, and factual news. Tell them you don’t want to hear TFG’s voice without also hearing the context and history of his dangerous, self-serving, and anti-patriotic lies. This time around, we don’t want an election narrative controlled by TFG and his minions. . . principally because, we do not want to grow up to be minions, which is precisely the future our news media is marching us toward.

Personal Reflections, Research, Writing

Concerns about Science

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As many of you know, over the past year or so I’ve been frustrated in my efforts to publish a couple of journal articles. I know I’m not the only one who has experienced this, but this morning we got another rejection (the third for this manuscript) that triggered me in a way that, as the feminists might say, raised my consciousness.

Three colleagues and I are trying to publish the outcomes from a short online “happiness workshop” I did a couple years ago for counseling students. Mostly the results were nonsignificant, except for the depression scale we used, which showed our workshop participants were less depressed than a non-random control group. Also, based on open-ended responses, participants seemed to find the workshop experience helpful and relevant to them in their lives.

Problems with the methodology in this study are obvious. In this most recent rejection, one reviewer noted the lack of “generalizability” of our data. I totally agree. The study has a relatively small n, nonrandom group assignment, yada, yada, yada. We acknowledge all this in the manuscript. Having a reviewer point out to us what we have readily acknowledged is annoying, but accurate. In fact, this rejection was accompanied by the most informed and reasonable reviews we’ve gotten yet.

Nevertheless, I immediately sent out a response email to the editor . . . which, because I’m partially all about entertainment, I’m sharing below. As you’ll see, for this rejection, my concerns are less with the reviews, and more about WHAT IS BEING PUBLISHED IN SO-CALLED SCIENTIFIC JOURNALS. Although I don’t think it’s necessary, I’ve anonymized my email so as to not incriminate anyone.

Dear Editor,

Thanks for your timely processing of our manuscript.

Overall, I believe your reviewers did a nice job of reading the manuscript, noting problems, and providing feedback. Being very familiar with the journal submission and feedback process, I want to compliment you and your reviewers on your evaluation of our manuscript. Compared to the quality of feedback I’ve obtained from other journals, you and your team did well.

Now I’d like to apologize in advance for the rest of this email because it’s a critique not only of your journal, but of counseling research more generally.

Despite your professional review, I have concerns about the decision, and rather than sit on them, I’m going to share them.

Although the reviews were accurate, and, as Reviewer 1 noted, there are generalizability concerns (but aren’t there always), I looked at the most recent online articles published in [your journal], to get a feel for the journal’s standards for generalizability, among other issues. What I found was disturbing.

In the seven published 2023 articles from your most recent issue, none have data that are even close to generalizable, and yet all of the articles offer recommendations, as if there were generalizable data. In the [first] article there’s an n of 8; [the second article] has an n of 6 and use a made-up questionnaire. I know these are qualitative studies, but, oh my, they don’t shy away from widely offering recommendations (is that not generalizing?), based on minimal data. Four of the articles in the most recent issue have no data; that’s okay, they’re interesting and may be useful. The only “empirical” study is a survey with n = 165, using a correlational analysis. But no information is provided on the % response to the survey, and so any justification for generalization is absent. Overall, some of these articles are interesting, and written by people I know and like. But none of them have anything close to what might be considered “generalizability.”

What’s most concerning to me is that none of the published articles employ an experimental design. My impression is that “Counselor Education and Preparation” (not just the journal, but the whole profession) mostly avoids experimental or quasi-experimental designs, and privileges qualitative research, or correlational designs that, of course, are really just open inquiries about the relationships among 2 or more variables.

This is the third rejection of this manuscript from counseling journals that, to be frank, essentially have no scientific impact factor. Maybe the manuscript is unpublishable. I would be open to that possibility if I didn’t read any of the published articles from [your journal and other journals]. My best guess (hypothesis) is that counseling journals have double standards; they allow generalizing statements from qualitative studies, but they hold experimental designs to inappropriately high standards. I say inappropriate here because all experimental designs are flawed in one way or another, and finding those flaws is easier than understanding them.

I know I’m biased, but my last problem with the rejection of this manuscript has to do with relevance. We tried to offer counseling students a short workshop intervention to help them cope with their COVID-related distress and distress in general–something that I think more counseling programs should do, and something that I think is innately relevant and potentially very meaningful to counseling students and practitioners.

Sorry again, for this email and it’s length, but I hope some of what I’ve shared is food for thought for you in your role as journal editor.

Thanks again for the timely review and feedback. I do appreciate the professionalism.

Sincerely,

John SF

If you’re still reading and following my incessant complaining, for your continued pleasure, now I’m pasting my email response to my coauthors, one of whom wrote us all this morning beginning with the word “Bummer.”

Hi There,

Yes! Another bummer.

For entertainment purposes, I kept you all on my email to the editor.

Although I’m clearly triggered, because I just read some articles in the [Journal], I now know, more about self-care, because in their [most recent lead published article], the authors wrote:

“Most participants also offered some recommendations for self-care practices to process crisis counseling. One participant (R2) indicated, “I keep a journal with prayers, thoughts and feelings, complaints and poetry.”

Now that I’ve done my complaining, I need to take time off to pray and write a poem or two, but then, yes . . .  I will continue to send this out into the world in hopes of eventual validation.

Happy Friday to you all,

John

I hope you all caught my clever utilization of recommendations from the offending journal to cope with this latest rejection. The good news is, like most rejections, this one was clarifying and inspired me with even more snark energy than I usually have.

Have a great weekend.

Happiness, Personal Reflections, Writing

To Complain or Not to Complain: Reflections on Publishing in Academic Journals

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This is one wide-ranging perspective

I like to THINK of myself as not being a complainer, but in reality, I do my share of complaining. One of my personal goals is to complain less and thereby avoid becoming a whining old curmudgeon. That’s a tall order because for me, there are always a few particular moments and experiences when it just feels VERY GRATIFYING to let the complaints fly.

Today, I’m offering some small complaints about the process of publishing in academic journals. I’m limiting my complaining and keeping a positive tone because too much complaining would be inconsistent with my anti-curmudgeon goal AND inconsistent with my topic: publishing happiness research.

Over the past year, I’ve started working on three different happiness manuscripts. We (my research team and I) submitted the first one (Manuscript 1) to a good journal, waited 3+ months and got a rejection. The rejection was understandable, but the reviews were IMHO uninspiring and uninformed. The reviewers critiqued parts of the manuscript that were absolutely solid, raised questions about non-issues, and completely missed the biggest flaw (of which I am very familiar, because I analyzed the data). In response, because reviews should nearly always be two-way, I provided a bit of congenial feedback to Editor 1. Editor 1 responded quickly and we had a cordial and constructive email discussion.

Manuscript 1 is now out to a second unnamed journal. We’re closing in on four months and so after recovering from my CACREP virtual site visit hangover (more minor complaining here in the midst of my major complaint) and using my congenial colleague voice, I emailed Editor 2. Again, I got a speedy and pleasant response. As it turns out, academic journal editors are generally lonely people who field so many hostile emails, that they’re very chatty when they get something nice. The editor of journal 2 shared a few frustrations. I responded with commiseration, and Editor 2 let me know we should hear about our manuscript’s status by the end of the week. Just in case you’re a lonely and frustrated academic journal editor and want to steal away this manuscript and publish it before Friday, I’ve pasted the abstract below. My Email is john.sf@mso.umt.edu.   

Effects of a Brief Workshop on Counseling Student Wellness in the Age of COVID-19

Abstract

Counselors-in-training (CITs) often experience stress, anxiety, depression, and other mental health issues. Teaching counseling students wellness and positive psychology skills, particularly in the age of COVID-19, may help CITs cultivate greater well-being. The purpose of this study was to investigate the effects of a brief happiness-oriented workshop on CIT well-being. Forty-five CITs participated in either a 2.5 hour online experiential evidence-based happiness workshop or control condition. Eight wellness-oriented self-report questionnaires were administered pre-and post-intervention. Compared with the control group, CITs who attended the online workshop reported significant reductions in depressive symptoms. At six-month follow-up, workshop participants were reported using several of the interventions (i.e., gratitude, savoring, and three good things) with themselves and in their work. Despite methodological limitations, this study provides initial evidence that a brief, online happiness workshop has promise for helping CITs cope with the emotional burdens of graduate school and COVID-19.

Manuscript 2 is based on one of my recent doctoral student’s dissertations. It’s a solid quantitative, quasi-experimental, pretest-posttest design with interesting and positive outcomes. We submitted it to a journal, waited 3 months, and then were informed that they liked the manuscript, but that it wasn’t a good fit for their journal. Being that I’ve become pretty chummy with various journal editors, I emailed the Editor using my happy voice, while also noting that it didn’t seem quite right that we waited 3 months to hear the manuscript wasn’t a good fit. We didn’t even get reviews. . . other than the editor’s mildly positive feedback. Editor 3 got right back to me and essentially agreed with my concerns and shared frustrations about journal editor and editorial board transitions. Just in case you’re tracking the pattern, it appears that academic journal editors are super into professional email exchanges. After getting Manuscript 2 rejected, I decided to start pre-emailing journal editors to check to see if the topic is a good fit for their journals. The responses have been fast and helpful. If by chance, you’re a fancy journal editor who’s feeling frustrated and wants a colleague like me for some email chats, you could increase your chances of hearing from me if you contact me and offer to publish Manuscript 2 . . . and so here’s the abstract.

Effects of a Multi-Component Positive Psychology Course on College Student Mental Health and Well-Being During COVID-19

Abstract

Even before COVID-19, college student mental health was an escalating problem. As a supplement to traditional counseling, positive psychology (aka happiness) courses have shown promise for improving college student well-being. We evaluated a unique, four-component positive psychology course on student mental health and wellness outcomes. Using a quantitative, quasi-experimental, pretest-posttest design, we compared the effects of the happiness course (n = 38) with an alternative class control condition (n = 41), on eight different mental health and well-being measures. Participants who completed the happiness course reported significantly higher positive affect, increased hope, better physical health, and greater perceived friendship support. In a post-hoc analysis of six happiness class participants who scored as severely depressed at pretest, all six had substantial reductions in self-reported depressive symptoms at posttest. Multicomponent positive psychology courses are a promising supplementary strategy for addressing college student mental health.

I know you’re probably wondering now, about Manuscript 3, which is under construction. The bottom line for Manuscript 3 is that it’s fabulous. Of course, because I haven’t submitted it anywhere yet, I’m the only reviewer offering feedback at this time. Manuscript 3 is the sort of manuscript that, I’m sure, a number of journals and journal editors will get in a bidding war over.

In the end, complaining is mostly unhealthy. Complaining can be like noxious weeds, with the negativity taking root, and spreading into areas where we should be staying positive and grateful. Too much complaining contributes to a sour disposition and outlook. On the positive side, complaining offers an opportunity for emotional ventilation, and can recruit interpersonal commiseration, both of which feel good. But IMHO the biggest potential benefit from complaining comes from social feedback. When people hear you complain, they can provide perspective. And yes, we all need perspective.

Happy Wednesday to everyone! May your complaints be minor and your perspective be multidimensional.

JSF

Personal Reflections, Writing

The Art of The Email

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Most of my life involves emailing.

Most of the time I take irrational pride in my emails. I work very hard to eliminate typos and grammatical problems. I also work very hard to give my emails just the right touch of snark and hilarity.

My goal is to send literary emails. I keep waiting for someone to publish them. Something like the Freud-Jung letters. But alas, no one has offered, and so, once again, I have to be the responsible party and do the right thing and publish them here.

My emails are in italics; the introduction to each email is not in italics.

  1. To an academic friend from Xavier University who wrote to me to share one of his student’s complaints about the fact that we said something positive about Paul-Michel Foucault in our Counseling and Psychotherapy Theories textbook:

Anyhow, I guess I’ll be cancelling Foucault in the future. I checked online, and the dude was a bad sexual predator creep. If it seems appropriate, offer my apologies to your student. It’s tough to stay up on all the idiotic creeps out there. When I read about them, I can’t figure out where they found the time to act out on all their stupid sexual perversions. Well, obviously, that’s not the only question I have . . .

2. To a former student who had the audacity to suggest she could beat me at games like Charades/Pictionary/Balderdash/Cards Against Humanity:

As someone who is a trained observer of human insecurities, I think you should know that when someone (like, let’s say, you) writes something like “You telling me you’ve never lost those games means nothing. . .” it’s a clear indication that whatever that person (like, let’s say, you) is writing about “means something.” You may be familiar with the protesting too much line from William S. . . . and he may have, indeed, been speaking of thou-est defense mechanisms.

If I cry during our upcoming competition, it will be from glee and not mushrooms or your game-playing domination fantasies.

Is the idea of using your corpse as a scarecrow an unusual idea? I’ve been away from human contact for so long that I’m not sure of what’s normal and what’s not and therefore take no personal responsibility for the normality of whatever I’m writing.

3. To the same former student (see above) who for some reason wrote to me about being open to being taxidermied after death and placed as a “greeter” on our porch:

You’re always so full of good ideas that I’m not sure what I can add. Back in the 20th century, we had a life-sized Jean Luc Picard cardboard cut-out that we kept on our porch to greet visitors. Should I outlive you, I’d be honored to keep your taxidermy self in our garden. Right now, Rita is writing about mushroom-based caskets as an alternative that results in quick biodegradation. We could put your likeness in a mushroom patch and then you might melt into the ground.

I probably should stop with all my good ideas now.

4. To an attorney who’s helping me with the details of a legal contract:

I’m glad to hear we’re outside the boundaries of HIPAA. One of my life goals is to pretty much always stay outside the boundaries of HIPAA. That’s why, when I ask people for their vaccination status, I also tell them I won’t be billing their insurance😊.

5. To a former student and professional counselor:

No one other than you would ever think to begin an email message with a statement about unmanned robot lawnmowers. I’d ask you about what you’re reading in your spare time, but I’m worried for what I might hear.

6. To my fellow faculty, when I forward them information I received from our national accrediting body:

Hi All,

I haven’t looked at this myself, but it seemed like I should pass it on.

7. To my Fall, 2021 Research class:

Hello Prospective Researchers,

It’s June, and anyone with any sense is thinking about the COUN 545 Research class right about now. Haha. Not really. I’m just procrastinating on other things.

I’m writing because I had emailed a few of you before saying that I would likely NOT be teaching the Research class . . . however . . . the excellent, very good news is that I WILL BE teaching the Research class. The plan is for us to be live, in-person, and following whatever health guidelines the University has in place for fall semester. I know, the good news just won’t stop.

I just wanted to clarify what’s happening and dispel any rumors and let you know in advance that we’ll be having the best research class experience ever.

More stuff will come your way (like a syllabus) in late July or early August. Until then, you should start systematically collecting data wherever you go and whatever you’re doing (sorry, more research jokes there, no need to do that).

Seriously, until then, you should have a fantastic summertime.

That’s all for now. And you all should have a fantastic June weekend!

John S-F

Cool Counseling, Counseling and Psychotherapy Theory and Practice, Suicide Assessment and Intervention, Writing

Working in the Cognitive Dimension

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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

Cool Counseling, Parenting, Writing

The Book . . . Again

2 Comments

Just for fun, here’s a photo of a page from our Suicide Assessment and Treatment Planning book. This page is the lead in to a section that focuses in on how to work with clients who are suicidal, but whom also may be naturally also experiencing irritability, hostility, and hopelessness. For info, go to the publisher, ACA: https://imis.counseling.org/store/detail.aspx?id=78174

Suicide Assessment and Intervention, Writing

Three ways for dealing with Annoying Blog Posts

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Just a heads up. I’ll be writing several posts about our new book this week. Be forewarned, these posts may be annoying. Annoying can happen when people feel enthusiastic. My apologies in advance.

In response to these upcoming posts from me (or annoying posts from others), you can apply one of three strategies.

  • You can respond with positive affirmation, sharing, and by empathically matching my enthusiasm. Keep in mind that positive affirmation may make me happy. The downside is you risk reinforcing my “new book posting” behavior.
  • You can respond with no response. That was a favored B.F. Skinner and Ivan Pavlov strategy. Think of it as putting me on a pain-free extinction schedule.
  • You can respond with negativity or punishment. Skinner, Adler, and child advocates oppose punishment, because punishment can backfire, causing undesired behavior to increase, or triggering erratic behaviors.

True confession: When reading offensive or annoying posts, sometimes, even though I know better, I give into temptation, and respond with negativity. That’s nearly always a bad idea, mostly because option #3 of the preceding list is a poor extinction strategy. In one recent study, when social media posts received highere numbers of negative responses, the original social media posters responded back with even more posts. In other words, attention—even negative attention—acts as positive reinforcement and often increases the behavior toward which it was aimed. The take-home message is that, generally speaking, if you want to extinguish annoying blog posting behavior, following Skinner’s and Pavlov’s advice makes for good behavioral strategy.

Although I’m wary of the possibility of you all putting me on an extinction schedule, below is an excerpt from the Preface of our fancy new book. Right now the book is only available on the publisher’s website (https://imis.counseling.org/store/detail.aspx?id=78174), but I suspect it will soon make its way over to Amazon and the rest of the booksellers.

Preface

Writing a book about suicide may not have been our best idea ever. Rita made the point more than once that reading and writing about suicide at the depth necessary to write a helpful book can affect one’s mood in a downward direction. She was right, of course. Her rightness inspired us to pay attention to the other side of the coin, so we decided to integrate positive psychology and the happiness literature into this book. As is often the case when grappling with matters of humanity, focusing on suicide led us to a deeper understanding of suicide’s complementary dialectic, a meaningful and fully-lived life, and that has been a very good thing.

Before diving into these pages, please consider the following.

Do the Self-Care Thing

            In the first chapter, we strongly emphasize how important it is to practice self-care when working with clients who are suicidal. Immersing ourselves in the suicide literature required a balancing focus on positive psychology and wellness. While you’re reading this book and exploring suicide, you cannot help but be emotionally impacted, and we cannot overstate the importance of you taking care of yourself throughout this process and into the future. You are the instrument through which you provide care for others . . . and so we highly encourage you to repeatedly do the self-care thing.

What is the Strengths-Based Approach?

            Many people have asked, “What on earth do you mean by a strengths-based approach to suicide assessment and treatment planning?” In response, we usually meander in and out of various bullet points, relational dynamics, assessment procedures, and try to emphasize that the approach is more than just strengths-based, it’s also wellness-oriented and holistic. By strengths-based, we mean that we recognize and nurture the existing and potential strengths of our clients. By wellness-oriented we mean that we believe in incorporating wellness activities into counseling and life. By holistic we mean that we focus on emotional, cognitive, interpersonal, physical, cultural-spiritual, behavioral, and contextual dimensions of living.

You will find the following strengths-based, wellness-oriented, and holistic principles woven into every chapter of this book.

  1. Historically, suicide ideation has been socially constructed as sinful, illegal, or a terribly frightening and bad illness. In contrast, we believe suicide ideation is a normal variation on human experience that typically stems from difficult environmental circumstances and excruciating emotional pain. Rather than fear client disclosures of suicidality, we welcome these disclosures because they offer an opportunity to connect deeply with distressed clients and provide therapeutic support.
  2. Although we believe risk factors, warning signs, protective factors, and suicide assessment instruments are important, we value relationship connections with clients over predictive formulae and technical procedures.
  3. We believe trust, empathy, collaboration, and rapport will improve the reliability, validity, and utility of data gathered during assessments. Consequently, we embrace the principles of therapeutic assessment.
  4. We believe that counseling practitioners need to ask directly about and explore suicide ideation using a normalizing frame or other sophisticated and empathic interviewing strategies.
  5. We believe traditional approaches to suicide assessment and treatment are excessively oriented toward psychopathology. To compensate for this pathology-orientation, we explicitly value and ask about clients’ positive experiences, personal strengths, and coping strategies.
  6. We believe the narrow pursuit of psychopathology causes clinicians to neglect a more complete assessment and case formulation of the whole person. To compensate, we use a holistic, seven-dimensional model to create a broader understanding of what’s hurting and what’s helping in each individual client’s life. 
  7. We value the positive emphasis of safety planning and coping skills development over the negative components of no-suicide contracts and efforts to eliminate suicidal thoughts.

Happiness, Personal Reflections, Writing

Goodbye 2020 . . . You’re Nothing but History Now

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Happy New Year!

As a method for putting 2020 behind me and focusing on a hopeful 2021, I engaged in some forward thinking (rather unusual for me) and wrote an op-ed piece for the Missoulian newspaper to be published TODAY! Below, I’ve pasted the beginning of the article, along with a link to the whole darn thing in the Missoulian. If you feel so moved, please share and like this. . . and I hope you experience the return of happiness in 2021.

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The Return of Happiness: Your 2021 Guide

Usually a great source of snarky humor, the Urban Dictionary lists its top definition for 2020 as, “The worst year ever.” Sadly, even the Urban Dictionary couldn’t find creative inspiration from the horrors of 2020. Goodbye, 2020; you will not be missed.

. . . for the rest of the article, click below:

https://missoulian.com/opinion/columnists/the-return-of-happiness-your-2021-guide/article_b513a4aa-a644-5dd6-8cd2-c6c23f7a1f83.html?utm_medium=social&utm_source=twitter&utm_campaign=user-share

Personal Reflections, Writing

In This Sacred Hour . . .

20 Comments

Yesterday, for Halloween, I dressed up as agitation. I wasn’t alone. Everywhere I went, everyone I saw, and around every corner, I encountered agitation. Maybe it was herd mentality. But no one developed immunity.

This too shall pass, and it did. Last night I took a deep breath and exhaled, slowly. And then like all the best Yogis, I lingered on the outbreath. My costume, all the layers of agitation, melted away onto the floor, into the carpet, down through the flooring, seeping back to the earth where agitation can rest.

Today is my favorite day; a day to throw myself into the gift of an extra, socially constructed, sacred hour. In stark contrast to all my previous years on the planet, today I plan to stay here—in this sacred hour—all day.

Having fallen back, no matter how long in coming, this particular hour arrives with surprise. What shall I do in this dark hour before dawn? Shall I spend it now, or wait and spend it with Rita on a walk up the river. Which hour of this 24 will be my sacred, extravagant, unexpected hour?

Every year, I’ve rushed into this gift. Anticipating its disappearance even before it appears, I’ve tried squeezing enough productivity into one arbitrary hour to compensate for my perpetual time management problems. But this is a new year, a new day, and a new hour, and, after shedding my agitation costume, I now see peace. It’s a bumpy peace, much like the washboard road to East Rosebud Lake. We may get rattled, but we shall arrive.

What I’d never discerned before is that the sacred hour is an illusion. Like many things, the sacred hour was created out of nothing but time for someone’s convenience and instead of recognizing its nothingness, I’ve tried to grab it, wrestle it to the ground, and suck out its imaginary nutrients. Year after year, I’ve mulled its significance and then experienced angst over how to spend it. As I do with Mary Oliver’s query, “Tell me, what is it you plan to do. With your one wild and precious life?” I’ve demurred. The question is too big. Everything will eventually vanish, and if I choose one thing I’ll be left with only one companion: my own judgmental vengeance.

Peaceful, deep breathing is almost always about the outbreath. Fancy meditators and Yoga practitioners coach us to pace our breathing, and then to extend the outbreath into the place of no-breath. Oddly, the place of no-breath is the place of life and peace, if only for snippets at a time. While being still, without breathing, for a second or three or six before the in-breath comes again, the body’s physiology slows down, nearly halting in parasympathetic bliss. In the sacred space of the outbreath, peace happens in the body, and when peace happens in the body it can—with practice—transfer little seedlings of peace to the mind. The common admonishment, “Remember to breathe” is less profound than its uncommon sister: “Remember to not breathe.” Remember to let yourself extend your peace for a bit longer than usual today. Remember to be with peace tomorrow. Especially, remember to mingle with peace on Tuesday. You know why.

Today’s brief illumination is that there’s nothing special and nothing especially sacred about this extra hour. But also, like all hours, there’s everything special and sacred about this extra hour. It’s just another hour that, along with its pesky minutes and seconds, was simply created for the convenience of counting.  

I’ll probably forget all this by Tuesday, but for today, I see every hour is a collaborative creation. Every hour we get to return to the beginning, resetting our intentions, and refocusing on the mystery of what is and what might be.  

Tuesday, Wednesday, and beyond will bring as many sacred hours as we can count. How shall we spend those hours? For me, I hope we can collectively linger with our outbreaths on Tuesday as we begin, together and again, to build peace, reclaim justice, embrace empathy, and restore democracy . . . one bumpy and sacred hour at a time.