Log in or sign up to comment
133 Comments Refresh
Posted by JasonR86

You're a good egg, Noonan Jason.

Awwww.

So I've been watching a lot of The Sopranos lately and it made me wonder how disclosure of illegal activities holds up against doctor patient confidentiality?

Here's when I can break confidentiality and when client information has to be released. But I can redact information that would go to a court or if a client were to ask for their records if I feel harm would come if that particularly information was disclosed. Just a quick thing, a court ordered released needs to be signed by a judge or a representative of a judge. A cop can't get those records without a court order and lawyers, try as they might, can't get records without a judge's order.

In terms of illegal activity, I can't release any information unless there's a likelihood of immediate harm as listed in that link I offered. Here's an odd issue. If a client reports past harm, like a murder that they committed, I can't tell the police or anyone about that crime because it already happened. I can only break confidentiality for immediate, future harm. Odd huh?

Posted by Everyones_A_Critic

@jasonr86: That is odd, I can't imagine someone confessing to an unsolved murder after the fact and just having to live with that information. That'd fuck me up big time.

Posted by JasonR86

@jasonr86: That is odd, I can't imagine someone confessing to an unsolved murder after the fact and just having to live with that information. That'd fuck me up big time.

I would imagine that a big chunk of that therapy would be on working with that person to admit to the crime him/herself because I could only imagine how that would fuck with someone's head. I could only imagine admitting to the crime, no matter the punishment, would be a relief.

Posted by Nasos100

@jasonr86: you diagnOSE you dont dignosis, its not a verb.

They just make everyone a doctor these days.

Posted by JasonR86

@nasos100 said:

@jasonr86: you diagnOSE you dont dignosis, its not a verb.

They just make everyone a doctor these days.

I diagnose when I do assessments. A mental health disorder is a type of diagnosis. Multiple disorders signify multiple diagnoses.

In all my replies, if I used the wrong term, then sue me.

Posted by ArtelinaRose

How do you feel about clients that enjoy playing violent video games?

Posted by Levio

Question: How do I know mental health advocates and professionals aren't really trying to deteriorate my mental health instead?

Edited by JasonR86

@artelinarose said:

How do you feel about clients that enjoy playing violent video games?

I think everything in life is best take in moderation, whether it is violent media or anything else. That said, I have no right to put my own values on to a client. If that client wants to do anything of any sort, as long as they don't put themselves or others in immediate harm, then I think it's fine. But I would say that if the media is making you feel a way you don't like or if it is interfering with other areas of your life I might focus the therapy on it more then the client might want. But, again, I have no right to make demands of a client (minus the whole putting self or others in danger thing).

@levio said:

Question: How do I know mental health advocates and professionals aren't really trying to deteriorate my mental health instead?

Those professionals and advocates typically have red, glowing eyes and horns coming out of their foreheads.

Edited by ArtelinaRose

@jasonr86 said:

@levio said:

Question: How do I know mental health advocates and professionals aren't really trying to deteriorate my mental health instead?

Those professionals and advocates typically have red, glowing eyes and horns coming out of their foreheads.

PUNISHED THERAPIST

A FALLEN LEGEND

Posted by Quarters

As someone who's becoming interested in this field and potentially working in it one day, this topic has been very fascinating to me. Awesome work, Jason.

Edited by ArtelinaRose

@quarters said:

As someone who's becoming interested in this field and potentially working in it one day, this topic has been very fascinating to me. Awesome work, Jason.

Yeah, I have been considering it. It seems like something I'd be good at considering how naturally it comes to me, and I want to be able to help people improve their lives, especially transgendered people looking to figure themselves out or begin transitioning. I just want to help somebody make a difference for/to themselves.

Posted by MariachiMacabre

Quick "Q" here, Doc. How do I, politely as possible, tell the worm in my head to stop mimicking the voice of my seventh grade Home Ec. teacher whenever he tells me to light something on fire? His name is Francis, by the way.

Online
Posted by JasonR86

Quick "Q" here, Doc. How do I, politely as possible, tell the worm in my head to stop mimicking the voice of my seventh grade Home Ec. teacher whenever he tells me to light something on fire? His name is Francis, by the way.

He just wants attention. Ignore him and you'll be fine.

Edited by MariachiMacabre

@jasonr86 said:

@mariachimacabre said:

Quick "Q" here, Doc. How do I, politely as possible, tell the worm in my head to stop mimicking the voice of my seventh grade Home Ec. teacher whenever he tells me to light something on fire? His name is Francis, by the way.

He just wants attention. Ignore him and you'll be fine.

Whenever I ignore him and makes me pick up a knife and hold it to my throat...

Online
Posted by JasonR86

@jasonr86 said:

@mariachimacabre said:

Quick "Q" here, Doc. How do I, politely as possible, tell the worm in my head to stop mimicking the voice of my seventh grade Home Ec. teacher whenever he tells me to light something on fire? His name is Francis, by the way.

He just wants attention. Ignore him and you'll be fine.

Whenever I ignore him and makes me pick up a knife and hold it to my throat...

You're probably fine.

Edited by MariachiMacabre

@jasonr86 said:

@mariachimacabre said:

@jasonr86 said:

@mariachimacabre said:

Quick "Q" here, Doc. How do I, politely as possible, tell the worm in my head to stop mimicking the voice of my seventh grade Home Ec. teacher whenever he tells me to light something on fire? His name is Francis, by the way.

He just wants attention. Ignore him and you'll be fine.

Whenever I ignore him and makes me pick up a knife and hold it to my throat...

You're probably fine.

Okay, I'm gonna trust you. You're the expert, I suppose. He's screaming that he's gonna cut out my voice box but he's probably just foolin'. Good thing I left my box cutter at home...no wait here it is. Ha! Have a good one, doc.

EDIT: I'm proud that this stupid, stupid post was my 6000th.

Online
Edited by medacris

@jasonr86: Thank you for making this thread. I want to go into something psych-related as well, and it's good to have someone on hand to explain the area to those that might not know much about it.

I did my History of Psych final on gamification. I wanted to show the positive aspects of gaming, and how it can help people bond together and learn. Unfortunately, a lot of the research I found didn't go into specific games, or the researchers had a very poor understanding of gaming in general. I tried my best with what I had, though.

@artelinarose: I wish you the best of luck in your transition!

Posted by ArtelinaRose

@medacris said:

@jasonr86: Thank you for making this thread. I want to go into something psych-related as well, and it's good to have someone on hand to explain the area to those that might not know much about it.

I did my History of Psych final on gamification. I wanted to show the positive aspects of gaming, and how it can help people bond together and learn. Unfortunately, a lot of the research I found didn't go into specific games, or the researchers had a very poor understanding of gaming in general. I tried my best with what I had, though.

@artelinarose: I wish you the best of luck in your transition!

thanks it will probably kill me

Posted by TruthTellah

@jasonr86 said:

@mariachimacabre said:

Quick "Q" here, Doc. How do I, politely as possible, tell the worm in my head to stop mimicking the voice of my seventh grade Home Ec. teacher whenever he tells me to light something on fire? His name is Francis, by the way.

He just wants attention. Ignore him and you'll be fine.

Whenever I ignore him and makes me pick up a knife and hold it to my throat...

I actually had a friend like this. He tried to deal with his multiple personalities by ignoring them, and one would threaten his life like that. He ended up killing himself.

Posted by zFUBARz

To the people looking into getting into the field, Just a heads up you can't really do much of anything with a BA, I mean you can but in the same way that a holistic priestess or what have you can give counselling, not saying there's not a place for it but it's a very different world from having a Phd or Masters as Jason has mentioned earlier.

@artelinarose: If you want to look into supporting others in situations like yours, There are lots of LGBT support networks out there, at schools, via community outreach programs, support centres, etc. It's a good place to start, will be a huge help later in life connection wise if you decide to get really involved and make a career out of it. Those places are always looking for help that actually understands the issues personally, I know my organization actively recruits volunteers that live with mental health issues themselves (directly or just in their lives) to help run programs in order to really help people open up. Somebody familiar with both trans and mental health issues could be very helpful/versatile.

Edited by Rick_Fingers

How did you feel on your very first day of work?

Posted by JasonR86

How did you feel on your very first day of work?

Nervous. The first time I did therapy I thought that I had no idea what I was doing and that I had just fooled everyone to get that master's because I didn't actually know a single thing.

Edited by ArtelinaRose

@jasonr86 said:

@rick_fingers said:

How did you feel on your very first day of work?

Nervous. The first time I did therapy I thought that I had no idea what I was doing and that I had just fooled everyone to get that master's because I didn't actually know a single thing.

DID you fool everybody?

Posted by JasonR86

@jasonr86 said:

@rick_fingers said:

How did you feel on your very first day of work?

Nervous. The first time I did therapy I thought that I had no idea what I was doing and that I had just fooled everyone to get that master's because I didn't actually know a single thing.

DID you fool everybody?

As it turns out I knew more then I thought. I also came into therapy thinking I was going to be the type of therapist that focuses on symptoms, giving out homework, and be task-oriented. I had no plans to focus on relationships. Turns out I focus primarily on relationships and most of all the therapeutic relationship which I never thought I would do.

The task-oriented, homework thing felt forced and didn't feel like it was focusing on what I was seeing with my clients. When I instead turned to relationships and the dynamic in the therapy room everything changed. All the sudden the therapy felt easier and more productive and my clients were more successful.

Edited by ArtelinaRose

@jasonr86 said:

@artelinarose said:

@jasonr86 said:

@rick_fingers said:

How did you feel on your very first day of work?

Nervous. The first time I did therapy I thought that I had no idea what I was doing and that I had just fooled everyone to get that master's because I didn't actually know a single thing.

DID you fool everybody?

As it turns out I knew more then I thought. I also came into therapy thinking I was going to be the type of therapist that focuses on symptoms, giving out homework, and be task-oriented. I had no plans to focus on relationships. Turns out I focus primarily on relationships and most of all the therapeutic relationship which I never thought I would do.

The task-oriented, homework thing felt forced and didn't feel like it was focusing on what I was seeing with my clients. When I instead turned to relationships and the dynamic in the therapy room everything changed. All the sudden the therapy felt easier and more productive and my clients were more successful.

Yeah, that makes sense. Mine has found very quickly that it's sometimes best to allow me to talk and talk and talk because I eventually reach a conclusion I wouldn't have before. She almost acts like an idea board for me, just having something or someone to bounce words off of makes it easier for me to think and approach things differently. Not that she doesn't say anything back...

Posted by SunBroZak

Not to turn this into a "Ask Shirley" column, but from someone who has experience, what would you do to combat melancholy? The not-quite depression, but still pretty shitty thing of feeling down, usually for no reason. I know there's some generic responses like "talk to someone about it", or "do something that makes you happy" but I'd still like to hear your opinion on it.

Online
Edited by zFUBARz

@jasonr86 said:

@artelinarose said:

@jasonr86 said:

@rick_fingers said:

How did you feel on your very first day of work?

Nervous. The first time I did therapy I thought that I had no idea what I was doing and that I had just fooled everyone to get that master's because I didn't actually know a single thing.

DID you fool everybody?

As it turns out I knew more then I thought. I also came into therapy thinking I was going to be the type of therapist that focuses on symptoms, giving out homework, and be task-oriented. I had no plans to focus on relationships. Turns out I focus primarily on relationships and most of all the therapeutic relationship which I never thought I would do.

The task-oriented, homework thing felt forced and didn't feel like it was focusing on what I was seeing with my clients. When I instead turned to relationships and the dynamic in the therapy room everything changed. All the sudden the therapy felt easier and more productive and my clients were more successful.

Yeah, that makes sense. Mine has found very quickly that it's sometimes best to allow me to talk and talk and talk because I eventually reach a conclusion I wouldn't have before. She almost acts like an idea board for me, just having something or someone to bounce words off of makes it easier for me to think and approach things differently. Not that she doesn't say anything back...

Mirroring, it's damn handy even in everyday life.

Posted by JasonR86

Not to turn this into a "Ask Shirley" column, but from someone who has experience, what would you do to combat melancholy? The not-quite depression, but still pretty shitty thing of feeling down, usually for no reason. I know there's some generic responses like "talk to someone about it", or "do something that makes you happy" but I'd still like to hear your opinion on it.

It really depends. One of the things I tell clients is that, no matter how hard one might try, it is really difficult to look at yourself objectively. There's probably something about your life that is leading to the sadness you are experiencing but it is hard to come to figure that out because we are all to close to ourselves to see what might be clear to someone other then ourselves.

What I would guess is that either there's something that is causing you to feel unfulfilled or there's something that is missing from your life that is causing you to feel this way. What I would probably try to do is ask questions about your life currently and in the past and try to gauge your overall satisfaction with these things. Then try to see what you would like to do that would make you feel more fulfilled. It could be anything that is causing or missing. Your job, your relationships, your hobbies, or anything else.

The basic thing is that there's something about your current situation in life that is making you feel unfulfilled. Probably. Again, it depends. But that would be where I would look first.

Edited by HerbieBug

@jay_ray said:

@jasonr86: Have you ever seen the HBO show In Treatment? Is that a good recreation of what therapy is like?

Okay, i first before I answer I should that I have spent about ten months in cognitive behavioural therapy (CBT) for primarily OCD issues in the past. I am also autistic and have a history of depression.

In my experience, the answer to your question would be no. But I realize there is a difference between CBT and the sort of, i don't know how to best describe, umm conversational therapy depicted on that program. In the case of CBT, the sessions are a great deal more structured, with specific long and short term goals. For instance, let's say a person wants to be able to walk away from their car without having to repeatedly turn around and come back to check and see if the door locks actually locked. You would do exercises and learn mind games that help in decreasing both the fear of what might happen if you don't check several times and increasing confidence that one check, as opposed to five or whatever it is, is enough to be certain. Like that. Goal and problem specific.

Posted by JasonR86

@herbiebug:

In the therapy I run, unless it is with a young kid, a couple, family, or group, I do more conversational therapy with a big focus on the therapy relationship. So my therapy might look like that show (though I still haven't watched it yet).

Edited by SpartyOn

@jasonr86: So I am a Master's student in I/O Psych right now so I majored in everything you wrote about, nice job. You say you're a therapist, but, as I'm sure you know, that's incredibly vague. What exactly is your degree in, what type of degree is it, etc? Just curious.

Edited by JasonR86

@spartyon:

It's a Masters in Clinical Psychology (as opposed to a Masters in Counseling). In my state that means I have a Licensed Mental Health Counselor (LMHC) license. The main difference between my degree and a counselor degree is that I had more training in assessments and more severe disorders whereas they had more training in group and family therapy.

Edited by SunBroZak

@jasonr86 said:

@sunbrozak said:

Not to turn this into a "Ask Shirley" column, but from someone who has experience, what would you do to combat melancholy? The not-quite depression, but still pretty shitty thing of feeling down, usually for no reason. I know there's some generic responses like "talk to someone about it", or "do something that makes you happy" but I'd still like to hear your opinion on it.

It really depends. One of the things I tell clients is that, no matter how hard one might try, it is really difficult to look at yourself objectively. There's probably something about your life that is leading to the sadness you are experiencing but it is hard to come to figure that out because we are all to close to ourselves to see what might be clear to someone other then ourselves.

What I would guess is that either there's something that is causing you to feel unfulfilled or there's something that is missing from your life that is causing you to feel this way. What I would probably try to do is ask questions about your life currently and in the past and try to gauge your overall satisfaction with these things. Then try to see what you would like to do that would make you feel more fulfilled. It could be anything that is causing or missing. Your job, your relationships, your hobbies, or anything else.

The basic thing is that there's something about your current situation in life that is making you feel unfulfilled. Probably. Again, it depends. But that would be where I would look first.

I see. Thanks for the advice.

Online