Wednesday, April 14, 2004

I just wanted to take this opportunity to say thank you to all my classmates and Dr. Combs. What I really enjoyed most about this class was everyone’s willingness to take risks by sharing their experiences, opinions and thoughts as well as securing a safe environment for those expressions. I think the elements of safety and humor are not present in some of our other classes and therefore we miss out on valuable discussions that could serve to further our development as psychologists. Although I have learned something valuable in every class, I found last week’s class especially meaningful as a classmate’s story shed light on difficulties that male therapists might face. I also gained a better understanding about how a supervisor and supervisee SHOULD handle a situation like the one that was role played. I think these applications are extremely important to our development as good psychologists and unfortunately we do not receive enough of them. So thank you to everyone in our class for contributing to my education and I hope I have done the same in some small way.

In response to Dr. Combs’ blog:
I agree that a good therapist already gives full attention during sessions, keeps up with the latest techniques because of extra time to engage in continuing education and offers a calm healing environment. The fact that a therapist would offer less to a client based upon their method of payment is rather sad and their adherence to ethical standards questionable. Although I see nothing wrong with a full fee cash practice, I do not favor the term VIC and would like to know what exactly is meant by “… giving extra attention and care to everyone I see”.

I know that we have standards about deception in research already, but does anyone in our class believe these guidelines are either too rigid or loose or do you believe we have found the appropriate balance? What about in relation to naturalistic field investigation studies?

Although I was already familiar with the Tuskegee study, it is always amazing to read what has been done in the name of science.

Wednesday, April 07, 2004

Finn & Tonsager Answers:

Pope article, Responsibilities in providing psychological test feedback to clients:
On p268, right column, first paragraph, Pope states that "clinicians may be uncomfortable discussing the results of an assessment with a client. Some may be reluctant to be the bearer of what they fear the client will receive as "bad news". Others may be uncomfortable trying to translate for the client the technical jargon that clogs so many test interpretation texts, computer interpretation printouts, volumes on diagnosis, and so forth. Still others may be uneasy facing a client's expectations of clear results with test results that may necessarily leave many important questions unanswered". Although this may be true as to why some psychologists do not provide adequate or appropriate testing feedback to clients, I do not believe that these are valid excuses. However, this type of practice appears to have become standard practice with many psychologists. Part of our profession as psychologists engaging in therapy, testing, treatment, etc. is to do things at times that make us feel uncomfortable. Think about how a client must feel after s/he completes a psychological test/battery as part of a treating clinician request and is never told what the test results indicated? If psychologists are so nervous about the client's reactions to the test results, fear having to answer additional questions or did not achieve clear results with the assessment and have important questions unanswered then that's just too bad and should not translate into lazy, avoidance driven practice. Clients should receive adequate feedback and although it may be time consuming, I believe Pope's idea on p.270 about taping the feedback session for the client to take with them is a great idea as well as the idea of the client adding their own written comments at the end of the report, describing their reactions to the process. Although this may not be suitable for all clients, I believe this feedback session can serve as an important experience in developing, maintaining or repairing the therapeutic alliance. I think not sharing a client's assessment results with them may be harmful to the therapeutic alliance as a client may believe that you have "the one up" on them as you may know something they did not intend.

Just as a quick note:
I agreed and enjoyed reading about Swann's self-verification theory. And even though a client may not agree with the self-enhancing feedback, it could serve as therapeutic goal. That is, just as the client has accepted negative self-verifying feedback, s/he could learn to accept some positive.

Website: The Rorschach Test:
I honestly do not know what to say about this website. It clearly helps people to perform "within normal range" and look happy and healthy. And even though the site displays its disclaimer, something about it just feels wrong. If we have time in class, I would really like to discuss this website.

Thursday, April 01, 2004

Interpersonal Theory website:
I found this website to provide a usable element of background information about IPT. In our training thus far, I did not know that Interpersonal theory is comprised of 3 strands of leading ideas: the principle of complementarity, the principle of vector length, and the principle of circumplex structure. This helps to shed some light in my understanding of IPT.

Ethical and Legal Dimensions of Supervision Website & Ch.10(Ethical Standards on Education and Training:
I think this website and CH.10 did a fabulous job of stating the standards and describing what supervision, education and training should constitute. Specifically, about what constitutes appropriate and inappropriate behavior by supervisors and professors. However, where is the advice, guidance and standards on how to realistically and safely address supervisors and professors who do not meet these standards? I know that everyone in our class at least one time in their academic career thus far has had to face a situation with a supervisor or professor that according to standards "should not" have happened. Is anyone willing to say that theyhad enough confidence in the system to appropriately handle this challenge? I believe that these standards are neccessary and serve a great purpose. However, unless a student is willing to risk posssibly a great deal, I question at times how well these standards truly work for students.
Although we have addressed this issue before, I believe our field of work is unique in that in order to become an effective, competent psychologist our "own stuff" must be addressed. At times, that "stuff" may play a role in supervision. While I believe that is ultimately a positive element to our development, it can be dangerous if not properly handled. There may be a fine line between supervision and therapy at moments.

Dawes article:

Thursday, March 18, 2004

Pope, Tabachnick & keith-Spiegel article:

This website is phenomenal as it provides NECESSARY and USEFUL information as well as links to other sites that can help psychologists and clients a like. It appears that the internet is becoming the primary source of information for many people and this site serves as a great example of easily accessible accurate information. I believe this website can help empower clients to better understand the field of psychology in general and what is appropriate or inappropriate behavior when working with a clinician as it addresses many areas. Although I viewed various articles and links, I found the pet bereavement link very interesting as this concept is typically minimized.
Article & Chapter 9:
Although we as psychologists are in the "business of helping others" we are still in business. After this week's readings, I still find myself at a loss as to why many psychologists and students at the clinic have difficulty discussing client payment. Do we not provide a service that is worthy of payment? Although many of us chose this profession because we like to help others, we also like to help ourselves. In any other profession, clients expect to pay for the services they receive so why are we any different. Why does collecting due payment or addressing nonpayment make many psychologists uncomfortable?

I found some of the percentages in the article to be shocking yet very insightful. For example, "Leading nude group therapy or "growth" groups" what in the world is that about? More importantly, I was surprised to learn that approximately 75% of psychologists would go to a client's special event or nearly 40% of psychologists would accept a client's invitation to a party. Where does there ethical awareness come in to play? If everyone is willing, I think it would be a great idea to informally administer this questionnaire to our class if not our program. I believe just as this study had lower reports of the identified behaviors than previous studies, ours would too.

Thursday, February 19, 2004


Thursday, February 12, 2004

Monahan Quiz Answers: 1D 2A 3B 4C 5? 6B 7B 8B
Question 5: If adding information to the patient's record after a violent event means tampering then my answer is (A) always wrong. If it doesn't, then adding or changing information is allowable as long as a legal case has not been filed and although legal it may not always be ethical.
The Ethics Side of Suicide website:
I realize that this is a hot topic that will probably never resolve itself in our life time and can always be discussed endlessly, BUT I will comment on it briefly and save my argument for our class discussion. I found this website informative, useful and probably one that I will revisit from time to time. With that being said, I also found this website to be biased. Without providing the most extreme examples to illustrate my point, here is my position. I agree that suicide in the overwhelming majority of cases is not the best choice that a person can make, however it is still a choice!!!! And not necessarily a decision that is made when “all other alternatives are exhausted and no other choices are seen”. Furthermore, I believe this directly relates to clinicians bringing their religious and moral values into the therapy room in addition to OUR society’s ideal of acceptable behavior. Suicide makes people feel uncomfortable-as it probably should, however just because we are trained in human behavior does not mean that we necessarily know what is best for every client. What’s good for the goose isn’t always good for the gander.
Sometimes clients may need to have the comfort/security or thought of suicide as a viable option to get through whatever painful ordeal they might be facing (even if they never act on it). Perhaps at these times, knowing that suicide is an ACCEPTABLE choice and choosing life instead may be therapeutic.
Ultimately it is the client who has control over his/her life and choices. Although we do have the power to affect a client’s choice not to commit suicide, we only have as much power as they truly allow us to. The client holds the power and to assume that we can control a client’s behavior stands against basic therapy principles. Furthermore, while I understand the realistic criminal and civil liabilities of having a client commit suicide, how much can we truly be liable if we don’t ultimately hold the power or the choice to prevent a client’s suicide? Finally, since “clinicians must strive to protect clients from harm”, why must death necessarily constitute harm?

Monahan article:
First I would like to point out that I found the practical knowledge of directly asking “what information relevant to risk is in the chart” and recording the answer if no mention is made in the transfer or discharge summary to be very useful as I have come across this problem more than once at my practicum. Secondly, although the changes in the APA Code of Conduct and Ethical Principles for Psychologists appears to provide more protection for psychologists, most of the literature I read leaves me questioning AT TIMES (only at times when I am not thinking about school work) if the risks in this profession are truly worth the profession itself. How could there not be a national legal standard for what clinicians should do when they assess risk? How are we supposed to successfully operate as a profession when we have difficulty coming to a consensus about many important concepts, such as this? Unfortunately, I believe that most of the difficulties we do have as a profession are our own fault. If we as psychologists do not push our agenda as a unified front, then no one will. In fact, we will continue to hold the same reputation in society and face the same biased problems.

Chapter 5: 2.06 a&b Personal problems and conflicts
While these standards are necessary and hopefully common sense, I believe that it may be difficult for some psychologists to realize that they are in such a position and need to take appropriate action (which we discussed in the first class). My point/question is that we serve as a check to our colleagues and while it is quite clear cut to tell a colleague that their alcoholism/drug abuse/sexual conduct with a client is preventing them from performing their work in a competent manner. Would it be different (if at all) if your colleague was not performing competently due to their being “burnt out” and having no other means of income or financial support?

Thursday, February 05, 2004

Bergin: In reading this article, the meaning of BALANCE remained prominent in my thoughts. Values and religion like everything else in life should have its place and hopefully be part of a larger balanced system. It is naïve to think that all psychologists will keep their values and religious views out of the therapy room. I am sure that all of us have heard stories about psychologists who have imposed their religion or their values on clients or those who have done harm to clients because their views color their perceptions. However, in reading this material I take away with me the same thoughts that I normally do: We as psychologists need to be AWARE of ourselves clients and colleagues.

Bergin: 1C 2B 3B 4D 5A 6D 7B 8B 9B 10D
Beahrs:1B 2C 3D 4A

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