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The Pocket Therapist: Mental Health To Go!

Imagine a GPS navigational system that said something like this: "In approximately 30 minutes, you will run into your old boss, who will want to make you feel like a worthless pile of feces. Erect personal boundaries immediately.... I said, Get in your bubble, Woman ... Are you listening? She's approaching you on your left. Lock up all childhood tapes now (the ones that convinced you that were weak, ugly, and pathetic) and DO NOT, I said DO NOT play them for her. Remember, their messages are no longer valid. Proceed carefully. You will speak to her in approximately 3, no 2, no 1 second."

Me? I would like one of those.

So I made one. In book form.

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Brain and Behavior

Google and Facebook, Therapists and Clients

With more and more therapists embracing social networking sites like Facebook and Twitter, the question arises -- where do you draw the line in terms of boundaries with your patients? Where does a patient's and therapist's privacy end or begin on such sites? How do patients and therapists navigate this brave new world of connectedness and "friending"?

Dana Scarton over at The Washington Post has the insightful article addressing this issue by talking to a number of therapists across the country. These therapists have had to deal with their own challenges with social networking sites and "researching" people online once it was brought into psychotherapy by a client or a client's actions.

Professional associations haven't addressed this kind of technology in their ethical guidelines, but common sense rules the day. As I just gave a presentation to therapists on this very topic, here's the upshot of what I had to say about this from a professional's point of view ...
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Why Psychologists Shouldn’t Prescribe

Beware psychiatrists bearing gifts.

If psychology wants to remain a science based upon the understanding of human behavior -- both normal and abnormal -- and helping those with the "abnormal" components, it would do well to avoid going down the road of prescription privileges. But perhaps it's already too late.

We first noted this disturbing trend in 2006, how they were shot down 9 out of 9 times trying to gain prescription privileges in 2007, and why prescription privileges for psychologists will eventually drive psychiatrists out of a job. We also noted that one of the programs setup to help psychologists get prescription training wasn't a "college" at all.

The fundamental problem with psychologists gaining prescription privileges is the inevitable decline over time in the use of psychotherapy by those same psychologists. This is precisely what happened to psychiatry -- they went from the psychotherapy providers of choice, to the medication prescribers of choice. Now it's hard to find a psychiatrist that even offers psychotherapy.
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Couch Surfing: When a Therapist Says It Isn’t a Good Fit

Most clients know what it feels like when they meet with a therapist and it isn't a good fit. Maybe you leave the initial session feeling misunderstood or knowing that the therapist’s personality or style isn't a good match for you. Maybe the therapist reminds you of someone in your life for whom you have negative feelings. Or maybe you can't stand her office or the location, or you recognize that the fee she charges is more than you can reasonably afford.

But what about when you think it's a good fit and the therapist doesn't? This can be uncomfortable -- particularly if it doesn’t match your perception of the connection you made. When a therapist tells you that she or he doesn't think it's a good fit or she doesn't believe she is the best person to help you, this can understandably be a little confusing. Maybe it even feels like a rejection.

There are multiple reasons why a therapist may not believe it is a good match, and unfortunately, we often don’t offer detailed explanations to clients. Sometimes there are good reasons for being less specific about it.

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Meeting With My First Therapy Client

I just finished a 40-day winter break from graduate school. After a quick but intense first semester, I was a bit crispy around the edges and welcomed the vacation. But now it is back to school and the next chapter in my journey towards becoming a clinical therapist.

In less than two weeks, I will be contacting my very first clients to set up appointments. Bless these people for actually volunteering to...
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Psychotherapy: How Much is Enough?

We recently posed a question to the New Mexico Psychological Association listserve about how long psychotherapy should last. We suspected that professionals may have wide disagreement about this issue. It involves a variety of important clinical and possibly ethical concerns.

Specifically, the issue is how long should psychotherapy last? Sounds simple enough to answer, but is it? Here are just a few of the thoughts we shared with the NMPA group:...
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5 Things Not to Worry About in Therapy

Psychotherapy is full of both extraordinary potential benefits and some possible pitfalls. We've discussed some of those things in past entries. But there are some things in psychotherapy that you just shouldn't spend too much time worrying about. They may seem important or worth worrying about, but it's just a waste of your time, energy and focus. Here's a few of them.

1. My therapist is judging me.

A lot...
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Anxiety and Panic

6 Ways to Manage Anxiety: Holiday Stress Tips

If you are like me, you're going to need some tips to manage your holiday stress. Here's my small contribution to your problem, some Holiday stress management.

If your mind were a diesel engine, anxiety would be the leaded gas that was accidentally poured in and responsible for all the burps and stutters. Even more so than depression, I think, anxiety is the big disabler in my life, with a capital D, which is why I try...
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Brain and Behavior

What’s Wrong with Positive Thinking?

I absolutely love this post that Tamar Chansky, , wrote specifically for Beyond Blue! You may remember her from another interview I did with her. She is a clinical psychologist, author of "Freeing Your Child From Negative Thinking" and other books, and a Huffington Post blogger. She's an expert on negative thinking -- how to turn it around to work for you. So I asked her to set us...
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Brain and Behavior

Can Therapy Really Change Your Brain?

I feel fortunate to be a psychotherapist in this day and age. Aside from the change we and our clients can report anecdotally, there is increasing evidence to support the potential for true change within the brain via the therapeutic relationship. I’m no expert in neuroscience and relationships – but am excited about the notion that people’s brains can be rewired within their intimate relationships...
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Children and Teens

Social Attachment, Motherhood, and Mental Illness

In early 2010, PBS will broadcast a 3-part series on emotions called "The Emotional Life," exploring ways to improve relationships, cope with emotional issues, and become more positive, resilient individuals. Hosted by Harvard psychologist and best-selling author Daniel Gilbert, the documentary weaves together the compelling personal stories of ordinary people and the latest scientific research, along with revealing comments from celebrities like Chevy Chase, Larry David, Elizabeth Gilbert, Alanis Morissette, Katie Couric and Richard Gere.

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Am I Depressed or Just Deep?

I spent my adolescence and teenage years obsessing about this question: Am I depressed or just deep?

When I was nine, I figured that I was a young Christian mystic because I related much more to the saints who lived centuries ago than to other nine-year-old girls who had crushes on boys. I couldn't understand how my sisters could waste quarters on a stupid video game when there were starving kids in Cambodia. Hello? Give them...
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