WKPIC welcomes our new doctoral interns, John Torres, Rain Blohm, and Crystal Bray! You’ll be hearing from them soon.
September 09 2015
August 08 2015
Farewell to the Class of 2014-2015
Summer ends, and so, too, does a year of internship at WKPIC. Good luck to Dr. Brittany Best, Dr. Graham Martin, and Dr. Faisal Roberts. Dr. Best moves on to a post-doctoral year in Hawaii (yes, we are all jealous), Dr. Martin is returning to his home state of Texas for his post-doctoral position, and Dr. Roberts is headed off to Pennsylvania for his post-doctoral year.
WKPIC staff knows you’ll do well wherever you go. We’re very proud of your accomplishments here–and no doubt we will hear good things about you in the future.
August 08 2015
Friday Factoids: Abandonment
Research has shown that therapists view termination as a complex stage of psychotherapy (Gelso & Woodhouse, 2002, as cited in Hardy & Woodhouse, 2006), though client responses are variable.
As cited by Hardy and Woodhouse (2006) clients often report positive feelings regarding termination, to include: pride, health, a sense of accomplishment, independence, cooperative, calmness, alive, agreeable, friendly, good, healthy, thoughtful, and satisfied. Interestingly, Hunsely, Aubry, Verstervelt, and Vito (1999) reported that 38.6% of clients attributed termination as a successful achievement of goals. Thus, Hardy and Woodhouse (2006) note that therapists may underestimate client perception of growth.
It is important that therapists become aware of these positive reactions, as psychotherapists may attribute more negative emotional reactions to termination. Additionally, understanding the difference between termination and abandonment is essential to ethical practice. Termination is a clinical decision based on competent practice. Per the ethics code, termination becomes clear when the client no longer needs services, is not likely to benefit, or is being harmed by continued service (American Psychological Association [APA], 2010). The latter may occur when a psychologist is not working within his or her boundaries of competence. Abandonment is an inappropriate termination (Behnke, 2009). Again, sound clinical thinking and consultation/supervision may help guide the decision process to ensure ethical termination. Yet, unfortunately termination can be more abrupt, such as in forced termination for interns (end of rotation)?
Often with forced termination, the goals of therapy have not been met and the provider may not handle the termination in an appropriate manner. Such may be due to lack of training. For instance, Zuckerman and Mitchell (2004) found that pre-doctoral interns reported they felt less than adequately prepared for forced termination. Thus, Hardy and Woodhouse (2006) highlight the need for focused training, specific to forced termination. According to the ethics code, pre-termination counseling is recommended (APA, 2010). With forced termination, often the end of services is known, therefore one should be proactive and notify the client in an appropriate manner. In other words, with termination, preparation of the client is necessary. When it is appropriate and after sound clinical decision-making and supervision, all efforts should be made to ensure an ethical termination and transfer to another provider occurs. Taking such care will help minimize harm and promote ethical practice.
References
American Psychological Association. (2010). Ethical Principles of Psychologists and Code of Conduct. Retrieved from http://www.apa.org/ethics/code/
Behnke, S. (2009). Termination and abandonment: A key ethical decision. Retrieved from http://www.apa.org/monitor/2009/09/ethics.aspx
Hardy, J. A. & Woodhouse, S. S. (2008, April). How We Say Goodbye: Research on Psychotherapy Termination. Retrieved from http://societyforpsychotherapy.org/say-goodbye-research-psychotherapy-termination
Hunsley, J., Aubry, T. D., Verstervelt, C. M., & Vito, D. (1999). Comparing therapist and client perspectives on reasons for psychotherapy termination. Psychotherapy, 36, 380-388.
Zuckerman, A., & Mitchell, C. L. (2004). Psychology interns’ perspectives on the forced termination of psychotherapy. The Clinical Supervisor, 23, 55-70.
Dannie S. Harris, M.A., M.A., M.A.Ed., Ed.S.
WKPIC Practicum Trainee
August 08 2015
Friday Factoids Catch-Up: Is Stress Contagious?
Research is demonstrating that stress can be contagious across various populations. In a study completed by Waters, West, and Mendes (2014) results indicate that babies quickly pick up their mother’s stress and show corresponding physiological (cardiac) changes. West et al. (2014) findings demonstrate that emotions may be communicated through a variety of channels, such as odor, vocal tension, facial expression, or touch. This leads to questions of whether these findings are applicable to adults or among strangers? Can stress still be contagious beyond the intimate bond of mother and child?
Findings from Engert, Plessow, Miller, Kirschbaum, and Singer (2014) show that observing others in a stressful situation can make your body release the stress hormone cortisol. The results show that being around a loved one or a stranger that is stressed results in quantifiable stress reactions. This study involved having subjects paired with loved ones and strangers of the opposite sex, and then divided participants into two groups. One group underwent challenging math questions and an interview to emulate a stressful situation, whereas the other group of 211 participants observed the test. Only 5% of the participants that were involved in the stressful situation remained calm, while the other 95% showed signs of stress. Interestingly, 26% of observers had increased cortisol indicating empathetic stress. When directly observed, empathetic stressed increased significantly when the observer watched a loved-one experience stress. Additionally, empathetic stress increased when observers watched a stranger in a stressful situation via video transmission.
Overall, stress is a major health threat in today’s society; even still, the likelihood of coming into contact with stressed individuals is also prominent (Max-Planck-Gesellschaft, 2014). Thus understanding the impact of stress and empathetic stress is important for developing prevention and/or intervention strategies. As Engert et al. (2014) suggest, we should be cautious of watching or observing stressful shows or other stimuli, as this may transmit stress to the viewers (Max-Planck-Gesellschaft, 2014). Also, the results of the study show that emotional closeness is a facilitator but not necessary to the experience of empathetic stress. Respective of these studies, the authors conclude “stress has enormous contagion potential” (Max-Planck-Gesellschaft, 2014).
References
Engert, V., Plessow, F., Miller, R., Kirschbaum, C., & Singer, T. (2014). Cortisol Increase in empathic stress is modulated by social closeness and observation modality. Psychoneuroendocrinology, 45, 192-201. DOI: 10.1016/j.psyneuen.2014.04.005
Waters, S. F., West, T. V., & Mendes, W. B. (2014). Stress contagion: Physiological covariation between mothers and infants. Psychological Science, 25(4), 934-942. doi: 10.1177/0956797613518352
Max-Planck-Gesellschaft. (2014). Your stress is my stress. Retrieved from http://www.mpg.de/research/stress-empathy
Dannie S. Harris, M.A., M.A., M.A.Ed., Ed.S.
WKPIC Practicum Trainee
August 08 2015
Managing My Illness?
How do I manage my illnesses? I go to my psychiatrist for tune-ups when I need it, and otherwise keep regular appointments with her. I go to my therapist as needed, and at one time was going weekly after my last hospitalization. The truth is…I don’t do all that I’m supposed to do all of the time. Why not? Because LIFE. I’m honest about it. I know what I’m SUPPOSED to be doing. I know what I did to get healthy. I know what I have to do to stay healthy….just sometimes, I don’t do those things, for various reasons. It shows up in my mental health.
As patients come in and out of the hospital, it may be frustrating to see the cycle. It may seem so simple to the average person. Just take your medicine. Go to your doctors. Why is it so hard? Because LIFE. I understand this. I am married to a very supportive person. He takes over the household responsibilities when I’m not doing well. If I have an exhausting day, he’s there to cook dinner for my two children, while he gives me time to rest. Not everyone has that.
I don’t always eat healthy meals, like I’m supposed to. The other day, I ate an Arby’s sausage biscuit for breakfast, a double cheeseburger from McDonald’s for lunch, and Taco Bell for supper. I’m still alive somehow. I don’t always get enough sleep, like I’m supposed to. I get too busy to make appointments with my therapist when I need to go. I try to be Super Mom to my kids, a Band Mom to 48 high school band kids, and work full time. Who has time to go to doctors, even if the therapist will see me on Saturday, which he will? That’s not an excuse, or shouldn’t be for me. It is incredibly easy to forget that I am not quite like everybody else, as much as I like to feel like I am. I can’t short-cut my health, or I might end up hospitalized again. Bipolar I is a serious mental illness, and I have it.
Medicine gets stolen (truly). Cars get flat tires and appointments are missed. Life gets overwhelming, especially when the mentally ill person has no one supporting them. It takes work to be a productive person who lives a self-directed life if one has a serious mental illness. Sometimes, despite good intentions and efforts, forces beyond the person’s control may keep the person from doing what he or she needs to do to become healthy. If you know someone with a mental illness, giving them a little support might make a world of difference.
Rebecca Coursey, KPS
Peer Support Specialist