WKPIC is thrilled to announce that we filled our 3 slots during Round I of Match this year–with awesome students! We extend a hearty welcome to Brittany Best, Faisal Roberts, and Graham Martin. We look forward to working with all of you come September!
Susan R. Vaught, Ph.D.
WKPIC Training Director
Many therapists see the same types of issues when working with teenage girls – girls struggle with their self-identity, low self-esteem, body issues, trying to fit in and ensure people will like and accept them.
Pipher (1994) in her book, Reviving Ophelia: Saving the Selves of Adolescent Girls, discusses these issues that adolescent girls deal with in their everyday lives. Pipher (1994) discusses a scene in which she was sitting on a bench outside of her favorite ice-cream store. She saw a mother and teenage daughter stop in front of her and wait for the light to change. She heard the mother say, “You have got to stop blackmailing your father and me. Every time you don’t get what you want, you tell us that you want to run away from home or kill yourself. What’s happened to you? You use to be able to handle not getting your way.” The daughter stared blankly straight ahead, barely acknowledging her mother’s words. The light changed and next she saw a very different scene. Another mother approached the same light with her preadolescent daughter. The mother and daughter were holding hands. The daughter said to the mother, “This is fun. Let’s do this all afternoon.”
Something very dramatic takes place to girls in early adolescence. Just as planes and ships disappear mysteriously into the Bermuda Triangle, so do the selves of girls. They crash and burn in a social and developmental Bermuda Triangle taking the happiness away from them. In early adolescence, studies show that girls’ IQ scores drop. Girls lose their assertive, energetic personalities and become more deferential, self-critical, and depressed. They report great unhappiness with their bodies. Girls are often happy and free but then loose themselves in adolescence. They often fall in love with boys and live only for their approval. Girls have no sense of inner direction; rather they struggle to meet the demands of others. Their value is determined only by their approval. A girl once said, “Everything good in me died in junior high.”
Pipher then discusses some interventions she uses with these adolescent girls. The most important question she says she asks her adolescent clients is “Who are you?” She says she is not as interested in the answer as in teaching a process that the girl can use for the rest of her life. The process involves looking within to find a true core of self, acknowledging unique gifts, accepting all feelings, not just socially acceptable ones, and making deep and firm decisions about values and meaning. It includes discussion about breaking the cultural rules set out for women and formulating new, healthy guidelines for the self. These girls must figure out ways to be independent from their parents and stay emotionally connected to them. They need to discover ways to achieve and still be loved. They must discover moral and meaningful ways to express their sexuality in a culture that blasts them with plastic, pathetic models of sexuality. They have to learn to respect themselves in a culture in which attractiveness is women’s most defining characteristic. Therefore, it is imperative that girls find, define, and maintain their true selves.
Pipher, M. (1994). Reviving ophelia: Saving the selves of adolescent girls. New York: Ballantine Books.
Cindy A. Geil, M.A.
WKPIC Doctoral Intern
Intelligence, self-discipline, or chance? What is the strongest contributor to success?
This is a complicated question. I think that it is too simplistic to think that the smarter you are, the more successful you will be. We can recall how many times we have completed an intelligence test when applying for a new job or a promotion. This obviously never happens. More likely consideration for a position is focused on past performance and achievement.
The above statement leaves out too many situational factors including perhaps the most important- self-discipline. Richard Nisbett discusses in his book, Intelligence and How to Get It: Why Schools and Cultures Count, the strong relationship between delayed gratification in the marshmallow experiment with children and their achievement scores in the future. The marshmallow experiment gives the participant the options of either receiving one marshmallow now or two marshmallows after a set time. Children who were able to wait longer to receive more marshmallows were more likely to have higher standardized achievement test scores.
However, Malcolm Gladwell wrote in his book, Outliers: The Story of Success, that immense success depends primarily on the special advantages one receives that make it possible to reach such success, once expertise has been achieve via the 10,000 Hour Rule. He cited such stories as how Bill Gates developed an affinity for computers and later achieved extreme wealth after he was given access to computers at a time when computers were not widely available. Gladwell argues that Gates would have likely been a successful professional, but perhaps not a professional worth $50 billion. Such high levels of success do not depend on raw aptitude and hard work alone.
So for now, there is no easy answer for my initial question. Like many complicated questions, there are many complicated answers. For more information on intelligence and success or for help forming an opinion of your own on this matter, you can check out the books I have discussed here:
Gladwell, M. (2009). Outliers: The story of success. Penguin UK.
Nisbett, R. E. (2009). Intelligence and how to get it: Why schools and cultures count. New York: W. W. Norton.
Cassandra Sturycz
Psychology Practicum Student
WKPIC is happy to announce that practicum student Cassandra Sturycz has been accepted to the doctoral program in clinical psychology at the University of Tulsa. She will be joining a psychophysiology laboratory for affective neuroscience. The lab was just awarded a sizeable grant from the NIH for research regarding pain in the Native American population.
Way to go, Cassandra!
Safety is the number one concern of patients admitted into an inpatient mental health facility. In theory, inpatient mental health facilities fulfill two goals: (1) to safeguard patients especially to patients at risk for suicide, and (2) to provide comprehensive services including, but not limited to medication management, individual/group psychotherapy, and effective diagnosis. The overall plan of care requires a collaborative effort consisting of psychologists, psychiatrists, social workers, nursing staff, the individual patient, and the patient’s family/primary support system. However, when an inpatient suicide takes place in a mental health facility, vulnerabilities must be carefully reviewed and addressed to help reduce and prevent the occurrence.
A study of Knoll’s (2008) article revealed frightening facts about the incidence of inpatient suicides. To support his findings, Knoll (as cited in the psychiatric-times.com) included information from the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) between 1995 -2005 (Knoll, 2008). According to JCAHO, as cited from Knoll (2008) and Burgess, Pirkis, Morton, and Croke (2000), “Suicides were the result of ineffective clinical assessment. The lack of risk management accounted for approximately 60% of suicides (Knoll, 2008; p.1) .”
Specific to inpatient facilities, Knoll indicated that hanging was the most recurrent method to commit suicide. Of particular interest, he indicated that approximately ¾ of inpatient deaths take place in the patient’s restroom, bedroom, or closet areas. Knoll also reminds personnel that items such as shoelaces, belts, straps, razors, etc., can potentially be weapons used by patients wishing to attempt suicide. Furthermore, there is a pattern of concern that has emerged in recent literature which suggests that inpatient facilities are: (1) inadequately monitoring patients, and (2) inadequately protecting first admit patients with thoughts of self harm, either moderate or severe. According to Knoll, these concerns have raised ethical concerns that question the efficacy of psychiatrists, psychologists, and the hospital staff to protect the patient from harm.
It is indeed a fact that hospitals face daily challenges. Knoll emphasized that sharing information is a daily challenge and has become a critical issue to the point that it is of the utmost significance that staff communicate with one another to identify patients who are a suicide risk. According to Knoll, communication or the lack thereof has contributed to a huge missing piece of the puzzle among the causes of suicide. He suggested ongoing staff education to focus on innovative suicide assessments and treatment. Knoll further stated that hospital staff should exercise caution when utilizing 15-minute checks with seriously suicidal patients who have been assessed as high risk or uncertain risk. He has also highlighted that inpatients can and do commit suicide while on 15-minute checks.
According to Knoll, too often will staff working in an inpatient environment get desensitized and no longer feel responsible for patient safety. It is believed that staff may become stressed and oftentimes lose impartiality that they view patients as scheming, manipulative, over-dependent, or feigning. In other words, suicide rates tend to increase when there is a breakdown of empathy, genuineness, and a lack of unconditional positive regard. The bottom line is that Knoll stresses that the highest-risk times for suicide are the first week after admission to an inpatient mental treatment facility and shortly after discharge. In short, conventional therapy interventions may prove ineffective and in some instances may exacerbate the risk of suicidal ideation. Therefore, mental health practitioners must implement out of the box thinking to approach patients who are at risk of suicide.
In summary, Knoll suggests that the mental health professional take a different point of view when caring for patients. Regardless of the mental health label, patient care should not be taken lightly. 1:1 close observation must be taken seriously. He states that the greatest risk of suicide is upon admission, especially when the patient being assessed is a first admit patient.
References
Knoll, J. L. (2008). Inpatient suicide: Identifying vulnerabilities in the hospital setting. Psychiatric Times, May 22, 2012. Retrieved from http://www.psychiatrictimes.com/suicide/inpatient-suicide-identifying-vulnerability-hospital-setting
Burgess, B., Pirkis, J., Morton, J., & Croke, E. (2000). Lessons from a comprehensive clinical audit of users of psychiatric services who committed suicide. Psychiatric Services, 51, 1555-1560.
David Wright, MA, MSW
WKPIC Doctoral Intern