WKPIC extends a giant congratulations to intern Anissa Pugh for her successful dissertation defense yesterday!!





Susan Redmond-Vaught, Ph.D.
Director, WKPIC

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Article Review: On Being Sane in Insane Places (Rosenhan, 1973)

Dr. David Rosenhan in 1973 conducted a study called On Being Sane in Insane Places to examine the reliability of staff, especially psychiatrist, in telling the difference between people who had severe psychiatric disorders and people who did not have these issues. Rosenhan produced eight pseudopatients who gained access to 12 different hospitals. Upon admission, all of the pseudopatients complained that they heard voices or sounds (“empty,” “hollow,” and “thud”) that were often unclear, unfamiliar, and of the same sex as the pseudopatients. Once admission was granted for the pseudopatients, all abnormal symptoms were discontinued and they behaved normally on the wards.


While the pseudopatients were on the psychiatric ward, staff would ask how they were feeling, and they all said fine. All the pseudopatients spoke to the other patients and staff as they regularly did. However, once being labeled schizophrenic, there was nothing a pseudopatient could do to overcome the diagnosis. The label of schizophrenia pathologized every aspect of the person’s behavior, as far as the staff were concerned. For example, all pseudopatients took extensive notes publicly but staff overlooked this activity. The closest questioning of the note taking occurred when a pseudopatient asked what medication they were receiving and began to write it down. The staff member then said, “You need not write it… If you have trouble remembering, just ask me again.”


In addition, Rosenhan noted that the pseudopatient behaviors that were stimulated by the environment were commonly misattributed to their disorder of schizophrenia. In other words, the patients’ behaviors were misinterpreted by staff as stemming from within the person, rather than the environment. For example, one of the pseudopatients was pacing in the long hospital corridor and a nurse asked were they nervous and the pseudopatient responded, “No, bored.” Interestingly, the patients on the psychiatric ward were able to question the normality of the pseudopatients and were suspicious of them, but not the staff. The main study results highlighted that there was a failure to detect sanity—and that the failure was that of the staff.


After the main study, Rosenhan conducted a second part where staff members were instructed to rate on a 10-point scale each new patient as to the likelihood that person was a pseudopatient. After examining the results out of 193 total patients, only 19 were rated by the psychiatrist and at least one other staff that the patient was suspected as a pseudopatient. In fact, Rosenhan had not sent any pseudopatients. These results suggested there was a failure in staff’s ability to detect pathology as well as sanity.


There is a long history at attempting to classify individuals with a disorder due to their symptoms and behavior. Currently the DSM-5 is used as a means to diagnosis one with a disorder based on specific criteria, which is more reliable, objective, and generalizable than the DSM-II that was used in the 1973. However, this study is still relevant and highlights biases, as well as stigma associated with diagnostic labels. In addition, it fosters a deeper look at our own role as practitioners, and encourages us to have a holistic view, and to be mindful to not pathologize every aspect of a person’s behavior.


Rosenhan, D.L. (1973). On being sane in insane places. Science, 179. 250-58


Katy Roth, M.A., CRC
WKPIC Doctoral Intern





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Friday Factoids Catch-Up: Self-Care During Internship


In my first Friday Factoid of the month, I mentioned that it is important to create friendships over the course of your internship.  I have learned it is not only important to have friendships within your cohort, but with other staff members at work who are not related to your department.  I have been lucky enough to have developed friendships with several individuals who understand my quirky nature and who are not afraid of having fun at work.



This year has been filled with too many fun shenanigans to talk about in just one blog post.  The two best shenanigans that have been talked about all over the hospital are our Unicorn Shirt days and Operation Cat Take Over.  On a random Thursday this year, a group of staff members decided to wear “I am a Unicorn” shirts along with unicorn headbands.  Not only did staff find these shirts entertaining, but several patients have asked if they could have the shirts.


By far the best shenanigan of the year not only started a department prank war, but WON the prank war.  It is said that on a Sunday afternoon two awesome, dedicated, and creative people entered the office of Will Battle.  Rumor has it that in 4 hours over 1200 cat pictures were hung across the entire office floor to ceiling with approximately 6 rolls of tape.   Pictures of this office do not do it justice so if you are ever at the hospital make sure to ask if you can see the “Cat Office.” 







Anissa Pugh, MA, LPA
WKPIC Doctoral Intern



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Friday Factoids Catch-Up: Self-Care During Internship

Many of the articles that provide tips on how to have a successful internship strongly encourage participation in self-care activities. We, as clinicians, frequently tell our clients to engage in self-care activities such as being outside, coloring, or listening to music. However, we are not always the best at taking our own advice.


I know over the course of this internship, I have had to work at incorporating self-care into my weekly routine. I have found that I not only need self-care activities outside of work, but also during my normal work day. One way I incorporate self-care into my work day is by getting out of the office for a few minutes several times a day. It started out just walking outside the building because there is always something to see on the grounds of WSH. At some point, I added a weekly Friday trip to Starbucks before seminar. On these trips, I realized I not only needed the caffeine, but I also needed to have a reward at the end of the week I could look for to. Now 10 months into internship, I may go to Starbucks more than is probably necessary, but it gives me a chance to get out of the office for a brief period of time.


Before you begin your internship year, I would suggest finding different ways you are going to incorporate self-care into your weekly routine.


Anissa Pugh, MA, LPA
WKPIC Doctoral Intern


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Friday Factoids Catch-Up: Having FUN on Internship

Congrats!!! You have officially matched with your internship placement for next year and that means one more stressful process cannot be taken off your long to-do list before graduation.  But just like other portions of your graduate school career, the actual internship can be stressful.  As clinicians we teach our clients a variety of coping skills to manage stress and instruct them to engage in self-care activities.  However, we usually don’t take our own advice and I know this has been a personal struggle for be during my internship placement.  That is why for the month of June the Friday Factoids are going to focus on how to survive your internship while not only growing as a professional, but also having fun at the same time.


There are a variety of articles online that give tips on how to have a successful internship and most of these articles incorporate the same aspects.  Tartokovsky (2016) composed a list of “8 Tips for a Successful Internship.”  Some of the tips from this were to learn as much as you can during internship, because you will most likely have a chance to do things you have never done before.  Something new you learn on internship may even become your specialty in the future.  Other tips discussed were talking with staff members and getting to know your cohort.  Internship can be stressful at times and you are going to need people to talk to both at work and in your personal life.


As I near the end of my internship placement, I got to thinking about things I did over the last nine months to ensure internship would be a memorable experience.  So over the next few weeks, I am going to show you some things I did as an intern that kept me calm including creating friendships, going on lots of Starbucks runs, and wearing unicorn shirts and headbands throughout the hospital.  Yes, you read that correctly unicorn shirts because sometimes you need to a good laugh when things get stressful (There is picture proof this happened).


Tartakovsky, M. (2016). 8 Tips for a Successful Internship. Psych Central. Retrieved on June 8, 2018, from


Anissa Pugh, MA, LPA
WKPIC Doctoral Intern



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Big giant hurrah for intern Crystal Henson, for successfully defending her dissertation!






Susan Redmond-Vaught, Ph.D.
Director, WKPIC

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Friday Factoid Catch-Up: The Porcupine Dilemma

Having a loved one with a mental illness can sometimes feel a lot like trying to love a porcupine. Schopenhauer and Freud have used a metaphor called the Porcupine Dilemma to describe what they feel is the state of the individual in relation to others.


This dilemma suggests that despite goodwill and the desire to have a close reciprocal relationship, porcupines cannot avoid hurting others with their sharp quills for reasons they cannot avoid. This typically results in cautious behavior and unstable relationships.

To work through this dilemma, if you have a loved one suffering with mental illness,  consider the following strategies:

  • Get involved in a community support program for emotional support and camaraderie.
  • Engage in self-care.
  • Encourage your loved one to initiate mental health services.
  • Communicate openly about your feelings, wants, and needs.



Georgetta Harris-Wyatt, MS
WKPIC Doctoral Intern


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Article Review: Sun, H., Takesian, A.E., Wang, T.T., Lippman-Bell, J.J., Hensch, T.K., Jensen, F.E. (2018). Early Seizures Prematurely Unsilence Auditory Synapses To Disrupt Thalamocortical Critical Period Plasticity

New research from Sun et al. (2018) has discovered a link between seizures early in development and autism.  Notably, these seizures occur during a critical period for the primary auditory cortex, a section of the brain important to language development.  It is hypothesized that these seizures disrupt the brain’s development, preventing typical language formation, and since these seizures are occurring during a critical period, this language does not develop unless acted upon (Sun et al., 2018).  Fortunately, Sun et al. (2018) found that acting upon the auditory cortex with activity dependent AMPA receptor (AMPAR) following the seizure but before the critical period allowed the brain to develop as expected, suggesting there is a remedy for these seizures if identified early enough.


This study does well in identifying the co-morbid diagnoses of autism or intellectual disabilities and epilepsy or other seizure disorders.  By recognizing this correlation, the team was able to recognize the possible connection between seizures interfering with the critical periods of neurodevelopment.  With this new research, autism and intellectual disability may become signficnatly less prevalent, however, research will need to continue developing the knowledgebase to assure this outcome.  Most notably, it will be important to help determine how best to identify these seizures prior to the critical period.  Additionally, research will need to find if other factors contribute to the presentation of autism and intellectual disability to continue our understanding of these causative factors and how they contribute to the development of these disorders.


Sun, H., Takesian, A.E., Wang, T.T., Lippman-Bell, J.J., Hensch, T.K., Jensen, F.E. (2018). Early seizures prematurely unsilence auditory synapses to disrupt thalamocortical critical period plasticity. Cell Reports, 23 (9), 2533. doi: 10.1016/j.celrep.2018.04.108


Michael Daniel, MA, LPA (temp)
WKPIC Doctoral Intern



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Friday Factoids Catch-Up: Toward Cultural Competence: Understanding Vicarious Group Trauma and Intergenerational Trauma in Jewish Individuals


The concept of vicarious group trauma is relevant for Jewish individuals because people who did not directly experience the Holocaust can still exhibit signs and symptoms of trauma exposure related to this event. Fuhr (2016) studied historical trauma related to Jewish individuals who lived in Britain. The researcher defined vicarious group trauma as, “A life or safety-threatening event or abuse that happened to some members of a social group, but is felt by other members as their own experience because of their personal affiliation with the group.” The research noted that these individuals can experience anxiety, perceptions of threat and hypervigilance simply due to their identification to the group, due to the magnitude of the trauma inflicted upon the group as a whole.


Cohn and Morrison (2017) found that in their sample, the trauma of the participants’ grandparents’ Holocaust experience impacted their own affective experience, their sense of connection to family history, their understanding of being different than others, and their political and ethnic values. Further, Abrams (1999) reported that when conducting therapeutic interventions, silence was a significant clinical feature in Jewish families contending with traumatic experiences. Survivors of a major historical trauma who remain silent are often condemned to desiccated existence, whereas those who speak out are susceptible to somatic consequences, psychosis, or even suicide (Rosenblum, 2009).

When conducting psychological treatment with people who are Jewish, it is important to be mindful of the historical trauma Jewish individuals have faced, and the fact that they may define themselves in collective manners as a part of a group of their ancestors who survived the Holocaust (Cohn & Morrison, 2017). Additionally, it is important to encompass thoughts about the effect on the individual level, the family level, and the environmental level, and confront patterns of the family that maintain burnout in the environment, as well as bring about appropriate structural change within the family to allow for safe expression and healing (Abrams, 1999). Abrams (1999) also noted that fostering open communication between older generations and younger generations can provide critical understanding and relief to families, lessening these collective effects.


Abrams, M. (1999). Intergenerational transmission of trauma: Recent contributions from the literature of family system approaches to treatment. American Journal of Psychotherapy, 53 (2), 225-231.


Cohn, I. G., & Morrison, N. M. (2017). Echoes of transgenerational trauma in the lived    experiences of Jewish Australian grandchildren of holocaust survivors. Australian Journal Of Psychology, doi:10.1111/ajpy.12194


Fuhr, C. (2016). Vicarious Group Trauma among British Jews. Qualitative Sociology, 39(3), 309-330. doi:10.1007/s11133-016-9337-4


Rosenblum, R. (2009). Postponing trauma: The dangers of telling. The International Journal Of Psychoanalysis, 90(6), 1319-1340. doi:10.1111/j.1745- 8315.2009.00171.x


Katy Roth, M.A., CRC
WKPIC Doctoral Intern



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Friday Factoids Catch-Up: Toward Cultural Competence: Understanding Historical/Generational Trauma of African Americans

Historical trauma is relevant to examine regarding African Americans because those who never experienced the traumatic stressor themselves, such as children and descendants of people who experienced race-based genocide/slavery, can still exhibit signs and symptoms of trauma. In the United States alone, African Americans have experienced over 350 years of oppression, generations of discrimination, slavery, colonialism, imperialism, racism, race-based segregation and poverty (Ross, n.d.).


In addition, African Americans currently are exposed to frequent and even multiple daily microaggressions, which are defined as, “Events involving discrimination, racism, and daily hassles that are targeted at individuals from diverse racial and ethnic groups” (Michaels, 2010). “Racial microaggressions are brief and commonplace, and include daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults toward people of color,” (Sue, Capodilupo, Torino, Bucceri, Holder, Nadal, & Esquilin, 2007). The impact of historical and generational trauma can affect people of color such that internal impressions/views of self begin to skew, and negative behavior and emotions such as anger, hatred, and aggression become self-inflicted, as well as imposed on members of one’s own group (Ross, n.d.).


Stigma related to mental illness also impacts views on mental health and help-seeking behaviors because African Americans who received services, as well as those with no prior experience with mental health services, associated these supports with embarrassment and shame (Thompson, Bazile & Akbar 2004). The researchers also found that African American participants in mental health services have mistrust around mental health practitioners, and that it may be challenging for psychologists and psychotherapists to be free of the attitudes and the beliefs of the larger society, especially due to stereotypes.


Asbury, Walker, Belgrave, Maholmes, and Green (1994) found that perceptions of provider competence, self-esteem, emotional support, and attitudes toward seeking services were significant predictors of seeking service. In addition, racial similarity, perception of provider competence, and perceptions of the service process determined continued participation. Pole, Gone, and Kulkarni, (2008) and Sue (1998) found that overall, African-Americans attended average to fewer sessions (underutilize services), as well as terminated from services earlier than European Americans.


When conducting psychological interventions with African Americans it is important to be mindful of their cultural beliefs, as well as current oppression (stereotypes) faced by this population, and to be culturally sensitive to the issues and experiences that the African-American community has historically confronted, and continues to experience (Ross, n.d.). When conducting psychological treatment with people of color, it is important to be mindful of the historical and generational trauma African Americans have faced, as well as keeping in mind how internal oppression can impact their views on mental health and help-seeking behaviors.


Asbury, C. A., Walker, S., Belgrave, F. Z., Maholmes, Green, L. (1994). Psychosocial,     cultural, and accessibility factors associated with participation of African  Americans in rehabilitation. Rehabilitation Psychology, 39, 113-121.


Michaels, C. (2010). Historical trauma and microagressions: A framework for culturally-  based practice. Children, Youth & Family Consortium’s Children’s Mental Health Program. Retrieved from


Pole, N., Gone, J. P., & Kulkarni, M. (2008). Posttraumatic Stress Disorder Among  Ethnoracial Minorities in the United States. Clinical Psychology: Science & Practice15(1), 35-61. doi:10.1111/j.1468-2850.2008.00109.x


Ross, K. (n. d). Impacts of historical trauma on African Americans and its effects on help-seeking behaviors. Presentation. Missouri Psychological Association.


Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. M. B., Nadal,     K. L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271-286.


Sue, S. (1998). In search of cultural competence in psychotherapy and counseling. American Psychologist, 53(4), 440-448.

Thompson, V. L., Bazile, A. & Akbar, M.D. (2004). African American’s Perceptions of Psychotherapy and Psychotherapists. Professional Psychology: Research and  Practice, 35, 19-26.


Katy Roth, M.A., CRC
WKPIC Doctoral Intern


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