Article Review: Frightening Truths About First Episode Psychosis: Results From a 2011 NAMI Survey



For many psychologists, greater experience comes at a costly price tag of desensitization. When conducting a routine structured interview, the phrase “Do you often hear or see things that others cannot?” would hardly elicit a noticeable response reaction, from even the most novice clinician. We may unintentionally disregard that the field of Human Services often times involves evaluating very real, sometimes very difficult human experiences.  Treating these experiences with the great humility and reverence they deserve can unfortunately sometimes fade with time.  It is therefore imperative that clinicians be hypervigilent and proactive in submerging themselves into research studies and literature, which aim to connect and help clinicians to understand these distressing experiences. Experiences such as psychosis can be extremely frightening, confusing and deeply personal not only for those experiencing it, but also for those closely related and wanting to help, like friends and family members.


The National Alliance on Mental Health conducted an online survey of people who experienced psychosis or witnessed a friend or family member have an episode of psychosis. The 2011 survey followed another NAMI survey that found that, on average, there is a nine-year gap between a person’s first psychotic episode and the time they begin to receive treatment for their diagnosis.


The 2011 NAMI survey also focused on finding the possible reasons why people with psychosis go close to a decade before receiving treatment, and possible solutions to solving the problem. First, there was the issue of lack of knowledge about psychosis. According to the survey, approximately 40 percent of the people who had psychosis said they were the first to recognize the problem themselves. These people reported that they realized something was wrong but they did not know what it was, due to lack of understanding about psychosis in general. This problem was compounded by the fact that many people who experience psychosis tend to isolate from others. According to the NAMI survey, around 20 percent of the responders reported that they did not receive help from friends or family when they had their first psychosis episode (NAMI, 2011). Lack of knowledge also proved to be a problem among family and friends. Just like the patients who experience a psychotic episode, family and close friends have a difficult time understanding and recognizing the symptoms of psychosis when they see it, making it difficult to get the help needed for their loved one.


A second challenge that prevents psychosis sufferers from receiving treatment is the stigma attached to mental illness. Again, this problem stems from lack of knowledge about psychosis. Respondents to the NAMI survey said that the issues they found the most challenging were confronting the stigma of mental illness, telling others about their psychosis, and worrying about no longer being taken seriously by others.


All these issues lead to a similar problem, which is, mental health professionals do not become a part of the treatment of patients who have psychosis, until many years down the line after their first episode. This is a significant obstacle to the treatment of psychosis because many of the respondents to the survey suggested that finding the “right” doctor, keeping appointments, and taking medication were very helpful in their treatment.


Observing the results of the NAMI survey, this writer believes that a comprehensive approach is necessary to solve the problem of delayed diagnosis of psychosis. According to the survey, many of the respondents said that they first received information about psychosis online. As such, putting relevant information online would be a good first step in educating the public about psychosis. Also, having an educational blitz in schools, workplaces and other institutions about psychosis would go a long way in both destigmatizing mental illness, and providing relevant information for people to get help for themselves and their family members.


Finally, understanding that psychosis can be a frightening, confusing, and very personal experience for any individual. The human exchange of simply gaining information and marking a check symbol in some box cannot (hopefully) be a comforting solution for any clinician, when uncovering someone’s experiences with psychosis.  In fact, if the tables were turned, what kind of qualities would you require from the person sitting across from you, before you felt comfortable enough to open up about such a deeply profound experience?


“The psychological equivalent to air, is to feel understood” – Stephen R. Covey





Dianne Rapsey-Vanburen, M.A.
WKPIC Doctoral Intern



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Friday Factoids Catch-Up: Differentiating Subgroups of ADHD

Penn State University (2016) researchers recently found that young adults with Attention-Deficit/Hyperactivity Disorder (ADHD) demonstrate subtle physiological signs that may help provide a more accurate diagnosis and possible identification of types of ADHD.  Their findings indicated that while engaged in a continuous motor task, individuals with ADHD had greater difficulty inhibiting motor responses and produced more force during the task compared to controls.  This research allowed for a more precise measure of motor responses compared to previous assessments based on key-press response.  Additionally, the amount of force was related to the self-report of ADHD symptoms of inattention, hyperactivity, and impulsivity.


The goal of this research was reportedly to help differentiate subgroups of those diagnosed with ADHD, which aims to inform treatment and offer diagnostic specificity.  The use of continuous performance tests (CPT) in ADHD assessments has yielded variable reviews, although the use of CPT in research has provided valuable information specific to ADHD (Bjorn, Uebel-von Sandersleben, Wiedmann, & Rothenberger, 2015).  Regardless, research indicates that CPT provides information specific to sustained attention and impulsivity, and can be utilized as a tool to aid diagnosis and per Penn State researchers, possibly identify more subtle signs that could directly inform treatment and interventions.



Albrecht, B., Uebel-von Sanderslebem, H., Wiedmann, K., & Rothenberger, A. (2015). ADHD history of the concept: the case of the continuous performance test. Current Developmental Disorders Reports, 2(1), p. 10-22.


Penn State. (2016). Inhibitory motor control problems may be unique identifier in adults with ADHD. Retrieved from


Dannie Harris, MA
WKPIC Doctoral Intern



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Friday Factoids Catch-Up: Impact of Trauma on Later Mental Illness

Palmier-Claus, Berry, Bucci, Mansell, and Varese (2016) found childhood adversity, described as neglect, bullying, and emotional, physical, or sexual abuse, was 2.63 times more likely to have occurred with individuals with bipolar disorder.


They note the effect of emotional abuse was particularly robust, with emotional abuse being 4 times more likely to have occurred with individuals with bipolar disorder.  Given the severity, course, and deleterious impact of this disorder on the individual and their family, highlights a need to identify risk factors that can inform treatment.  Similar findings have shown a link between childhood adversity and other mental disorders.  Specifically, Matheson, Shepherd, Pinchbeck, Laurens, and Carr (2013) found medium to large effect size of childhood adversity with individuals with schizophrenia.


Thus, for both bipolar disorder and schizophrenia, research suggests childhood adversity as a possible risk factor for development of these disorders.



Matheson, S. L., Shepherd, A. M., Pinchbeck, R. M., Laurens, K. R., & Carr, V. J. (2013). Childhood adversity in schizophrenia: a systematic meta-analysis. Psychological Medicine, 43(2), 225-238.


Palmier-Claus, J. E., Berry, K., Bucci, S., Mansell, W., & Varese, F. (2016). Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. The British Journal of Psychiatry, 209(6), 454-459.


Dannie Harris, MA
WKPIC Doctoral Intern



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Friday Factoids Catch-Up: Teens and Legalization of Marijuana

Gruber and Sagar (2017) highlight concerns of legalization of marijuana and its potential impact on adolescents.  They suggest that with legalization, adolescents may develop beliefs that marijuana use is acceptable or harmless.  Gruber and Sagar (2017) indicate that there is increased vulnerability for individuals under 25 using marijuana.  More specifically, research has shown the brain is still developing during this time period, with critical executive functioning skills developing into the mid-20s.


Research has demonstrated marijuana use that began in adolescence has been linked to problems with memory and increased marijuana use in the future.  Furthermore, those with more frequent and chronic use have been shown to have increased problems with cognition and memory.  Other studies have shown marijuana use has been linked to psychosis (Di Forti et al., 2014; Di Forti et al., 2015), as well as damage to the corpus collosum with use of high potency marijuana (Rigucci et al., 2015).  Gruber and Sagar (2017) suggest concerns with potency, in that some products may have higher levels of tetrahydrocannabibol (THC) compared to others, as well as when compared to marijuana used decades ago.  There is concern that policy has “outpaced science” (Gruber & Sagar, 2017, p. 2), indicating that proper research has not yet been accomplished relative to the legalization and established polices.


As a result, consideration regarding age restrictions, restriction of advertising to youth, and determining guidelines for use is recommended.



Di Forti, M.,  Sallis, H., Allegri, F., Trotta, A., Ferraro, L., Stilo, S. A.,…Murray, R. M.(2014). Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. Schizophrenia Bulletin, 40(6), 1509-1517.


Di Forti, M., Macroni, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M.,…Murray, R. M. (2015). Proportion of patients in south London with first-episode psychosis is attributable to use of high potency cannabis: a case-control study. Retrieved from


Gruber, S. A., & Sagar, K. A. (2017). Marijuana on the mind? The impact of marijuana on cognition, brain structure, and brain function, and related public policy implications. Retrieved from www.
Rigucci, S., Margues, T. R., Di Forti, M. Taylor, H., Dell’Acqua, F., Mondelli, V.,…Dazzan, P. (2015). High potency cannabis affects corpus collosum (CC) microstructural organization. European Psychiatry, 30, 291.


Dannie Harris, MA
WKPIC Doctoral Intern



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Friday Factoid Catch-Up: Teen Coping Strategies

A recent article in the New York Times by Lisa Damour (2017) discussed coping strategies of teenagers.  Along with feedback from practicing psychologists, Damour provided some interesting descriptors of coping mechanisms that may be criticized or possibly overlooked by adults.  The author notes that it is common for teenagers to reread childhood books or re-watch television shows or movies that they used to love when younger to cope with stress.  These simple tasks have been shown to lift spirits and improve a depressed mood.  Here the revisiting of youthful activities or completing simple or repetitive tasks may help teenagers distract themselves from expectations or personal demands.


The article suggests that teens who use approach coping mechanisms, such as problem solving, are more satisfied with their lives compared to teens that use avoidance coping strategies (e.g., ignoring or worrying). Parents can help monitor if distractions or coping strategies are adaptive or interfering with one’s responsibilities.  Identifying the source of stress as either something that can be changed or something that is out of one’s control is also necessary and may influence the type of coping skills that could be useful.  Also the author highlights that some situations may be beyond a child’s capacity to handle or manage without support (e.g., death, trauma); therefore professional support may be beneficial.  In short, parents may find it helpful to recognize that coping mechanisms are personal, and though these activities may appear rudimentary, their effects have shown to have a positive effect on how teens manage stress.



Damour, L. (2017). When a teenager’s coping mechanisms is SpongeBob. Retrieved from


Dannie Harris, MA
WKPIC Doctoral Intern


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Article Review: Marek, R. J., Heinberg, L. J., Lavery, M., Rish, J M., & Ashton, K. (2016)’s A Review of Psychological Assessment Instruments For Use in Bariatric Surgery Evaluations


Marek, Heinberg, Lavery, Rish, and Ashton (2016) offer a thorough review of psychological assessment instruments for bariatric surgery patients.  Through their literature review, they highlight the association of pre-surgical psychological factors with weight gain post-op and recurrence of behavioral problems. Additionally, they note that bariatric patients have a higher prevalence for psychological disorders compared to the general population (Kalarchian et al., 2007; Mitchell, Selzer, et al., 2012, as cited in as cited in Marek, Heinberg, Lavery, Rish, & Ashtom, 2016). Thus, and consistent with their review, the National Institute of Health (NIH) has recommend psychological assessment for bariatric surgical candidates.  The authors highlight the goals for such an evaluation are to “identify and treat preexisting psychopathology,” “identify patients who may need additional postoperative care,” and to “identify alternative treatment strategies” if a patient is deemed not appropriate for a selected procedure (Block & Sarwer, as cited in Marek et al., 2016, p. 1143).


The authors review the domains of a semi-structured interview for the assessment of bariatric surgery candidates and provide references for the clinical interview (see references for information on clinical interviews).  They indicate that though many practitioners use common broadband assessments (i.e., MMPI-2 or BID-II), the instruments used tend to vary and often lack sound psychometric properties for use with this population. In general, they recommend that the psychological domains of internalizing psychopathology, eating-related behaviors, externalizing psychopathology, and thought disorder or poor cognitive functioning be assessed.  The authors indicate that depression and anxiety are prevalent among this population, and further note that antidepressants may be inadequately absorbed after surgery (Roerig et al., 2012; as cited in Marek et al., 2016).  If left untreated, alcohol and substance use are contraindicated with this surgical procedure.  Marek et al. (2016) state that “pharmacokinetic changes following some bariatric surgery procedures further accelerate alcohol absorption, making postsurgical risk of alcohol misuse problematic” (p. 1144). Further, continued marijuana use may impact eating habits; while the effects of other substances are currently unknown.  Finally, an unstable or untreated thought disorder is considered contraindicated for bariatric procedures. Here, concerns of weight gain from psychiatric medications, side effects from anesthesia (e.g., delirium), adherence and understanding of the procedure and aftercare, and deficits in neurocognitive domains are considered to be significant factors that could lead to problems post-surgery.


The authors offer a thorough review of several common assessment instruments used in bariatric surgery evaluations. For the broadband instruments, the Minnesota Multiphasic Personality Inventory, Second Edition (MMPI-2) is the most widely used, and the Minnesota Multiphasic Personality Inventory, Second Edition-Restructured Form (MMPI-2-RF) also shows good reliability, validity, and predictive utility.  Marek et al. (2016) reported preference for the MMPI-2-RF with this population. The authors highlight concerns with MMPI-2 profile elevations related to underreporting as this response style may not only suppress clinical scales, but also may indicate an underreporting on other self-report measures. High scores on the hysteria, masculinity/femininity, and paranoia scales, along with elevations of Health Concerns and the Infrequency scale differentiated patients who lost less than 50 percent of their weight.  The Personality Assessment Inventory (PAI) is less commonly used, but is suggested as a viable option. The Symptom Item Checklist-90-Revised (SCL-90-R) lacks validity scales and assessment of externalizing psychopathology; yet based on past research, bariatric patients that score higher on depression, anxiety, and hostility scales were more likely to be delayed for surgery. The Million Behavioral Medication Diagnostic (MBMD) has bariatric normative data and report options, yet there is limited psychometric data published. Research with the Millon Clinical Multiaxial Inventory-II (MCMI-II) suggested patients with elevation on scales of schizoid, schizotypal, and compulsiveness had less weight loss 6 months post-surgery. However, the authors note that the MBMD and MCMI-II lack adequate research supporting the use with this population. For the Basic Personality Inventory, low alienation scores were associated with successful weight loss.


Narrowband instruments can function as a supplement to gauge eating disorder behavior or other specific domains of concern.  For depression and anxiety, the Beck Depression Inventory, Second Edition (BDI-II) is suggested to be an adequate screening measure, and per research findings (Hayden et al., 2012, as cited in Marek et al., 2016) a cutoff score of 13 should be utilized.  The authors suggest additional discriminant validity is needed for use of the BDI-II with this population. The Patient Health Questinnaire-9 (PHQ-9) is also a useful screening tool and is a strong choice with his population per Marek et al. (2016).  The authors suggest a recommended cutoff of 15 to indicate further screening for depression. The Mood Disorders Questionnaire (MDQ) has good sensitivity for assessing bipolar spectrum symptoms, with a recommended cutoff of less than 7.  The Beck Anxiety Inventory has good reliability and validity for use with this population. The Center for Epidemiologic Studies Depression Scale and the Generalized Anxiety Disorder-7 lack psychometric data for use with bariatric assessments.


For substance abuse screening, the Alcohol Use Disorders Identification Test (AUDIT) has good sensitivity and specificity for use with bariatric populations. The Michigan Alcoholism Screening Test is useful but may be more so reflective of lifetime use rather than more recent drinking patterns; furthermore, psychometric properties have not been reported with bariatric samples.  The Substance Abuse Subtle Screening Inventory-3 has shown to have low sensitivity in identifying alcohol dependence in some populations.  There also is reportedly no data relative to bariatric samples.


Instruments to assess eating behaviors are useful in identifying persistent eating disorder pathology, which may contributed to less successful weight loss post-surgery. The authors recommend that an evaluation of eating behaviors be included in bariatric assessments, as well as the need to confirm reported eating behavior through a clinical interview. The Eating Disorders Examination Questionnaire is commonly used and has strong internal consistency and validity. The Questionnaire of Eating and Weight Patterns-Revised is the most commonly utilized measure in the literature. It assesses behavioral aspects of disordered eating, as well as weight history and body image.  The Three-Factor Eating Questionnaire assesses restraint, hunger, and disinhibition. This instrument is used frequently and has shown to be able to distinguish between binge eating and non-binge eating.  The Binge Eating Scale is also commonly used and is able to distinguish between minimal, moderate, and severe binge eating problems; however, this instrument should be used with caution due to a tendency to over diagnose.  The Eating Disorders Inventory-III has been validated with obese populations, but not with bariatric populations. The 11 subscales provide assessment for drive for thinness, bulimia, body dissatisfaction, ineffectiveness, perfectionism, interpersonal distrust, introceptive awareness, maturity fears, asceticism, impulse regulation, and social insecurity. The Night Eating Questionnaire assesses severity of nocturnal ingestion, evening hyperphagia, morning anorexic, and mood/sleep problems. It has also been validated with weight loss surgery candidates and the authors recommend this as a component of the assessment, though more psychometric development is needed.  To assess for loss of control related to binge eating, the Loss of Control Eating Scale has shown good psychometric properties. The concept of loss of control is noted to be predictive of psychopathology and distress rather than the amount of food consumed.


Overall, a broadband assessment appears necessary to assess and rule out existing psychopathology that either is contraindicated with weight loss surgery or to target treatment in order to maximize benefits post-surgery. Furthermore, though a clinical interview is necessary to diagnose disorders, the use of screening measures to support diagnoses or to suggest areas of intervention is recommended.  Interestingly despite recommendation by the NIH for pre-surgical evaluation, only about two-thirds of bariatric surgery clinics reportedly adhere to this recommendation (Marek et al., 2016).  The use of psychological testing helps provide normative data and additional evidence to support a diagnosis, aid in treatment planning, and assess behavioral tendencies (eating patterns, substance use).  The use of a broadband measure that assesses response styles is also necessary.  Interpretation of response styles can help guide decision making and diagnosis.  Marek et al. (2016) further indicated that a portion of bariatric surgery patients minimize psychopathology, specifically impulse-control and sensation-seeking.  Overall, Marek et al. (2016) suggest the assessment of eating, mood, and substance use is the foundation for bariatric assessments, with the overall goal to enhance the evaluation in order to inform treatment and decision making to best assist patients.


Finally, for additional information on templates for a structured clinical interview and recommendations to include in the interview, see the references below:


Sogg, S., & Mori, D. L (2004). The Boston Interview for Gastric Bypass: Determining the psychological suitability of surgical candidates. Obesity Surgery, 14, 370-380.


Sogg, S., & Mori, D. L. (2009). Psychosocial evaluation for bariatric surgery: The Boston Interview and opportunities for intervention. Obesity Surgery, 19, 369-377.


Dannie S. Harris, MA
WKPIC Doctoral Intern



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Friday Factoids: Robots could help solve social care crisis, and evolutionarily destroy the function of our mirror neurons at the same time! (How wonderful?)



International teams of engineers are developing humanoid robots to deal with our ‘social care crisis’.


Tasked with the responsibility to interact with the elderly in care homes, these ‘personal social’ robots will be able to be specifically programed to match the personality type of the people they will be working with. According to a British Broadcasting Communication (BBC) article, “It is hoped the new robots will help improve the well-being of their charges by providing entertainment and enabling them to connect better, through smart appliances, with family and the outside world.”


My question to you is, what would you do if you could build yourself a robot? Posing this very question to an exceptionally scholarly and brilliant 13-year-old girl (and highly favored niece), I attempted to address this issue. According to her, if she had a clone robot, she would have the robot do all her chores and homework, so she could have the free time to, you guessed it, socialize (the sweet irony of an upcoming Generation Z’er). I suppose this is the sentiment shared by most, which is to have technology do our dirty work, like making our food, cleaning up after us, and now doing our Therapy, so we could then have the free time to do what we really want, perhaps connecting with other people.


That is the purpose of technology in theory. In practice however, I am noticing the opposite. As we progress into the information age, where the world is flat; I recognize that people are becoming less connected. Yes, we are coming into contact with more and more people, but we are ‘connecting’ with fewer. Weekly, we are adding to the already hundreds of ‘friends’ we have on Facebook, while grandpa plays chess with a robot. In the information age, our communication is becoming limited to 140 characters tweets or less and Facebook postings of the Panera sandwich and Kale smoothie we had for lunch (because our friends really want to know). Still, we wonder why we feel depressed and lonely.


I have an idea. Maybe we should give grants to engineers to program robots to do our Tweeting, so we could have more time to spend with our grandparents.


Robots could help solve social care crisis, say academics<>[×9/p04r8ghc.jpg


Dianne Rapsey-Vanburen, M.A.
WKPIC Doctoral Intern



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Friday Factoids Catch-Up: If You Want To Be An Effective Therapist, You Should Learn How To Use POTT!!!


Research findings have finally drawn our attention to something tantalizingly useful: the benefits of POTT use among therapist. Even better news, its cost effective, sharing is encouraged and it is totally legal to use in any state at any time of the day.  Now before you go running off to throw away that “medicinal” prescription sheet you have been hoarding in your nightstand and cancelling that dream vacation trip to Amsterdam; there is something you should be aware of. “POTT” stands for Person-Of-The-Therapist-Training. A unique training program offered to students, POTT was “designed to facilitate clinicians’ ability to consciously and purposefully use their selves to effectively connect, assess and intervene with clients,” within the treatment process (Nino, Kissil, Cooke, 2016.)


Building on a collective of other research that highlights the importance of the “therapeutic alliance” as being a definitive factor in most treatment successes.  Person-Of-The-Therapist-Training aims to foster the therapeutic relationship between client and clinician, by identifying and building on the therapist empathic strengths (i.e. via past personal experiences).


The underlining theme to this body of research seems to be that the most effective asset in therapy is the human asset.  The idea that a therapist can draw from his or her past experiences, and effectively transform this energy into highly effective, empathic skills is something of a phenomenon. The concept of the “wounded healer,” has often shown up in various forms of literature, over a vast multitude of disciplines. However, Person-Of-The-Therapist-Training appears to make an effort to capture this elusive dynamic system by packaging it into neat categories, that us clinicians cannot seem to live without, testable data.  Whether or not rating and evaluating past personal experiences and training students to be empathic with clients is an actual thing (perhaps you have empathy or you don’t) one thing seems certain. Psychology (and all other related human service fields) is in the business of connecting to people and building relationships. It may not matter what theoretical orientation we come from, or what therapy language we use to convey our understanding and willingness to help someone in need. And since being human is not some part time job that can readily be dismissed, and may possibly be the most effective tool you have when trying to connect with someone in pain. Why not use it. Do we really need research and training, to confirm and teach us that?


Or maybe we could have just saved a ton of time and funding, and just watched the kids movie Kung Fu Panda:


“There is no secret ingredient in the secret ingredient soup….its just you.


Niño, A., Kissil, K., & Cooke, L. (2016). Training for Connection: Students’
Perceptions of the Effects of the Person-of-the-Therapist Training on Their Therapeutic Relationships. Journal Of Marital And Family Therapy, doi:10.1111/jmft.12167


Dianne Rapsey-VanBuren,
WKPIC Intern



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Friday Factoids Catch-Up: City Interns Have Higher Burnout!

City Interns, have higher burnout rates!


Or, one current intern’s shameful –but heartfelt-plug, to incoming interns.


Going through this stressful ordeal only one year ago, I often wondered about the creators of the psychology internship process? Obviously, self-care, mindfulness and mental health were not the cornerstones by which this gem was hatched. The process starts when you are at the final stages of finishing your academic year, in addition to practicum (thankfully no other life exists outside these two realms for us budding psychologists).


Forcefully sucking out any refreshing accomplishment air, you attempt to gasp as you scramble to get your letters of recommendations and essays written before those heart stopping due dates. And as the first official semester break (and I use the term ‘break’ very loosely) approaches, you gather with family and loved ones to celebrate Thanksgiving; those infamous letters start arriving! I mean really….Can’t we just at least enjoy a turkey leg in peace, without feeling so relentlessly pressured? I remember thinking about those sites who choose to send their rejection letters the day before, or day of Thanksgiving. Seriously? At least the pilgrims had the heart to offer corn before the big fallout. I simply emotionally bandaged myself up that day, comforted myself (CBT style), bowed my head with the rest of the family at the dinner table, and offered my own secret version of the Thanksgiving prayer:  “Dear God, thank you for a bullet well-dodged.”


It is sometimes painful to watch what we psychologist do to each other, in the name of advancement. Not to mention our statisticians and psychometricians who for some reason fail to recall that the holiday seasons usually marks the height of suicide rate among our population and possibly not the best times to send those letters. Perhaps maybe it Freudian-slipped their minds. Nevertheless, we students bear and push through the pain, adding continuous enormous debt as we optimistically back-pack across the nation (again, statistically the worse time of the year for travel) in search of that perfect internship. Relentlessly we attempt to convince ourselves that sweet, peaceful, victory is just around the turn.


And, cue Burnout.


Where does it all end, or does it ever? Here is one article to consider when deciding how much emotional stamina you have left, as you prepare to assess and ultimately rank your internship interview experience:  City interns have greater burnout rates.


Apparently the growing number of stress related symptoms reported by graduates seeking mental health services while on internship prompted Doctors in the UK to study the relationship between internship and burnout. What they found is far from any earth shattering enlightenment to our generation, which is, interns sleep less, are more sad and stressed out (simplifying the results to its bare minimum)–especially those interns living in big city, and working in high-paced environments.


Luckily, there are places that offer high quality, APA-accredited internship programs like WKPIC in Kentucky (yes, another shameless plug) that come without the high burnout price tag those big cities bring.


A small start, but definitely something to CBT about.


Gallagher, P. (2013). City interns ‘are at greater risk of Burnout’. The Independent Retrieved from


Dianne Rapsey-VanBuren,
WKPIC Intern


(Director’s Note: We at WKPIC approve this shameless plug!)


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Friday Factoids Catch-Up: CBT, Anxiety Reduction, and First Episode Psychosis


Did you know that teaching a single day CBT workshop on anxiety reduction techniques and interventions, can significantly help clients with First Episode Psychosis?


A study conducted with clients experiencing First Episode Psychosis with co-morbid anxiety symptoms who were offered a single day CBT workshop on anxiety reduction techniques yielded the following results:

1) Participants reported a lessening of anxious symptoms following intervention; and

2) Participants reported that they “felt they were more likely to make use of the skills in the future.”


This study seems to once again reiterate both the effectiveness and ‘cost benefits’ of CBT, within an ever-shrinking pool of resources within the health care field.


Maybe it is true what they say after all, “teach a man how to fish….”


Welfare-Wilson, Alison; Jones, Amy (2015). A CBT-based anxiety management workshop in first-episode psychosis. British Journal of Nursing, 24(7): 378-382. doi:


Dianne Rapsey-VanBuren
WKPIC Doctoral Intern



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