PhD/PsyD RANT: Arguing with therapists with no research background is like screaming at the ocean and begging the waves to subside

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ClinicalABA said:
Ok- I've done some more "research", and I'm leaning towards Swiftgron. The tattoo removal seems like more than just a coincidence. I'm not buying the whole "collage is a composite of Swift/Kloss" argument. That said, I couldn't figure out umlauts when searching, so trying to investigate the Toe stuff just got me a bunch of pictures of Taylor Swift's feet, which I quickly closed so as not to be placed on any FBI watch lists or risk not passing my next CORI check.

To keep with the OP and not be a pure derail- I think empiricist often assume that empiricism (and the consequent logical positivism) is EVERYONE's dominant epistemology, and argue from this perspective. To assert that the empirical research does not support position A to someone who believes that the statements of their Crystal Shaman support position B is futile. The time used doing so would be better spent reading a book, doing the dishes, or trimming your toenails.

Now let's talk about Hetlor...
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ClinicalABA said:
Ok- I've done some more "research", and I'm leaning towards Swiftgron. The tattoo removal seems like more than just a coincidence. I'm not buying the whole "collage is a composite of Swift/Kloss" argument. That said, I couldn't figure out umlauts when searching, so trying to investigate the Toe stuff just got me a bunch of pictures of Taylor Swift's feet, which I quickly closed so as not to be placed on any FBI watch lists or risk not passing my next CORI check.

To keep with the OP and not be a pure derail- I think empiricist often assume that empiricism (and the consequent logical positivism) is EVERYONE's dominant epistemology, and argue from this perspective. To assert that the empirical research does not support position A to someone who believes that the statements of their Crystal Shaman support position B is futile. The time used doing so would be better spent reading a book, doing the dishes, or trimming your toenails.

Now let's talk about Hetlor...
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Lots of GRE words :)
 
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ClinicalABA said:
Ok- I've done some more "research", and I'm leaning towards Swiftgron. The tattoo removal seems like more than just a coincidence. I'm not buying the whole "collage is a composite of Swift/Kloss" argument. That said, I couldn't figure out umlauts when searching, so trying to investigate the Toe stuff just got me a bunch of pictures of Taylor Swift's feet, which I quickly closed so as not to be placed on any FBI watch lists or risk not passing my next CORI check.

To keep with the OP and not be a pure derail- I think empiricist often assume that empiricism (and the consequent logical positivism) is EVERYONE's dominant epistemology, and argue from this perspective. To assert that the empirical research does not support position A to someone who believes that the statements of their Crystal Shaman support position B is futile. The time used doing so would be better spent reading a book, doing the dishes, or trimming your toenails.

Now let's talk about Hetlor...
Click to expand...

To me, both Swiftgron and Kaylor almost certainly happened, between Wonderland/the tattoo and Dianna's tumblr URL/"hi Taylor" for Dianna and the Vogue photoshoot/romantic road trip Instagram photos/"now I'm your daisy" (seriously, there's no non-Kaylor explanation for that lyric)/the "Best Best Friends" video for Karlie. But I agree that the Kaylor colleague eye theory is a bit insane and don't buy it. Toe with an umulat refers to the theory that Taylor and Zoe Kravitz hooked up and/or were together (I could go either way on this). Toe without the umulat refers to Taylor and Joe Alwyn as a couple--Gaylors vary on whether they think Toe are actually together romantically, in some sort of queer platonic relationship (I'm here), or bearding contractually (although Grammygate was the most transactional thing I've ever seen, so Idk). I could buy Taylor being bi but just not with Joe, because those two seem deeply unpassionate about each other.

(I'm having a ****ty week--my grandma died--so thanks for letting me talk about this; it's a nice distraction! :) )
 
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futureapppsy2 said:
To me, both Swiftgron and Kaylor almost certainly happened, between Wonderland/the tattoo and Dianna's tumblr URL/"hi Taylor" for Dianna and the Vogue photoshoot/romantic road trip Instagram photos/"now I'm your daisy" (seriously, there's no non-Kaylor explanation for that lyric)/the "Best Best Friends" video for Karlie. But I agree that the Kaylor colleague eye theory is a bit insane and don't buy it. Toe with an umulat refers to the theory that Taylor and Zoe Kravitz hooked up and/or were together (I could go either way on this). Toe without the umulat refers to Taylor and Joe Alwyn as a couple--Gaylors vary on whether they think Toe are actually together romantically, in some sort of queer platonic relationship (I'm here), or bearding contractually (although Grammygate was the most transactional thing I've ever seen, so Idk). I could buy Taylor being bi but just not with Joe, because those two seem deeply unpassionate about each other.

(I'm having a ****ty week--my grandma died--so thanks for letting me talk about this; it's a nice distraction! :) )
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We all need diversions at times, and this is a perfect one- somewhat silly, but still juicy; let’s us vicariously get involved in the steamy details of the lives of the beautiful people; no real major impact on us regardless of the outcome; etc.

My condolences on your loss.
 
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ClinicalABA said:
We all need diversions at times, and this is a perfect one- somewhat silly, but still juicy; let’s us vicariously get involved in the steamy details of the lives of the beautiful people; no real major impact on us regardless of the outcome; etc.

My condolences on your loss.
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Thanks. There's an interesting disconnect between knowing on a cognitive level that the death of someone in their late 80s relatively quickly and painlessly and with only a few years of health issues proceeding that isn't really a medical tradegy and, OTOH, having it still hurt emotionally, because, well, she was my grandmother.

Returning to Gaylor, though, that Karlie/Taylor Big Sur road trip really was what turned me into a Gaylor, because that was just the clearest glass to closet in. :)
 
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This means my kid has autism, right?

Where do I get my free puzzle piece tattoo?
 

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AcronymAllergy said:
How long do we think it'll take for the authors of the study to start receiving death threats from the TikTok faithful?
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The venn diagram of "faithful TikTok users" and "reader's of the Canadian Journal of Psychiatry" is a two non-ovelapping circles (more like a circle and a dot, respectively).
 
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Some ideas of people not trained in research in response to a colleague asking for help in treating a patient with insomnia:|

"I'd refer to a hippy dippy therapist who can do a combo of SE/ energy work. This client may need to move into the realm of ancestral/past life clearing, or something else esoteric depending on where they developed the fear on am energetic level (does client report hx of seeing things from the spirit realm?)"

"Take a family history. Gas anyone in the previous 2 generations has any trauma to his knowledge. Was a trauma in the history mentioned growing up. 2. With panic, it's important to know the first episode. May provide some insights. 3. What's the deepest fear? It's puzzling EMDR produced no improvement. Makes me wonder if the targets and NC were correctly identified."

"Trauma is stored in the nervous system.
Craniosacral Therapy tones the nervous system. The therapist stabilizes the nervous system using co regulation and therapeutic touch.
Slowly trauma rises to the surface to release.
Health is established as a foundation and baseline of nervous system regulation."

I don't know if I should cry, laugh, or just be horrified. I am surprised that Witchcraft and bloodletting were not mentioned.
 
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msc545 said:
Some ideas of people not trained in research in response to a colleague asking for help in treating a patient with insomnia:|

"I'd refer to a hippy dippy therapist who can do a combo of SE/ energy work. This client may need to move into the realm of ancestral/past life clearing, or something else esoteric depending on where they developed the fear on am energetic level (does client report hx of seeing things from the spirit realm?)"

"Take a family history. Gas anyone in the previous 2 generations has any trauma to his knowledge. Was a trauma in the history mentioned growing up. 2. With panic, it's important to know the first episode. May provide some insights. 3. What's the deepest fear? It's puzzling EMDR produced no improvement. Makes me wonder if the targets and NC were correctly identified."

"Trauma is stored in the nervous system.
Craniosacral Therapy tones the nervous system. The therapist stabilizes the nervous system using co regulation and therapeutic touch.
Slowly trauma rises to the surface to release.
Health is established as a foundation and baseline of nervous system regulation."

I don't know if I should cry, laugh, or just be horrified. I am surprised that Witchcraft and bloodletting were not mentioned.
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Hehe. Reminds me of when I am hanging out at the yoga studio. I love the meditation and benefits of mindfulness, but the hippy dippy stuff gets a bit deep at times. 😂
 
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msc545 said:
Some ideas of people not trained in research in response to a colleague asking for help in treating a patient with insomnia:|

"I'd refer to a hippy dippy therapist who can do a combo of SE/ energy work. This client may need to move into the realm of ancestral/past life clearing, or something else esoteric depending on where they developed the fear on am energetic level (does client report hx of seeing things from the spirit realm?)"

"Take a family history. Gas anyone in the previous 2 generations has any trauma to his knowledge. Was a trauma in the history mentioned growing up. 2. With panic, it's important to know the first episode. May provide some insights. 3. What's the deepest fear? It's puzzling EMDR produced no improvement. Makes me wonder if the targets and NC were correctly identified."

"Trauma is stored in the nervous system.
Craniosacral Therapy tones the nervous system. The therapist stabilizes the nervous system using co regulation and therapeutic touch.
Slowly trauma rises to the surface to release.
Health is established as a foundation and baseline of nervous system regulation."

I don't know if I should cry, laugh, or just be horrified. I am surprised that Witchcraft and bloodletting were not mentioned.
Click to expand...
"Trauma is stored in the nervous system."
- I'll never start cringing when I hear that statement...where to even begin?

"Muscle memory."
Yeah...I know what they 'mean' when they're saying it (and it [and by 'it' I mean the phenomenon of behavioral performance becoming more automatic and skillful over time with repeated practice)...but it still causes me to do an internal 'double-take' whenever I hear it and I refuse to use the term myself under any circumstances.

"I have a TBI...I have 'brain damage.'"
- history of a single event 10+ years ago which--based on extensive interviewing with a team of professionals--may or may not have actually involved a concussion; denied loss of consciousness, may have had an alteration in consciousness, is assumed to be the 'cause' of any current problems with irritability, insomnia, poor impulse control, joblessness/homelessness, etc.
 
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msc545 said:
Some ideas of people not trained in research in response to a colleague asking for help in treating a patient with insomnia:|

"I'd refer to a hippy dippy therapist who can do a combo of SE/ energy work. This client may need to move into the realm of ancestral/past life clearing, or something else esoteric depending on where they developed the fear on am energetic level (does client report hx of seeing things from the spirit realm?)"

"Take a family history. Gas anyone in the previous 2 generations has any trauma to his knowledge. Was a trauma in the history mentioned growing up. 2. With panic, it's important to know the first episode. May provide some insights. 3. What's the deepest fear? It's puzzling EMDR produced no improvement. Makes me wonder if the targets and NC were correctly identified."

"Trauma is stored in the nervous system.
Craniosacral Therapy tones the nervous system. The therapist stabilizes the nervous system using co regulation and therapeutic touch.
Slowly trauma rises to the surface to release.
Health is established as a foundation and baseline of nervous system regulation."

I don't know if I should cry, laugh, or just be horrified. I am surprised that Witchcraft and bloodletting were not mentioned.
Click to expand...

This is physically hurting me.
 
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The number of people seeking stimulants seems to have certainly increased from when i started residency years ago to present day attending life. I get so many people who have decided they have ADHD and social media is definitely negatively influencing this. Ugh. And cant argue with them because they have decided their self diagnosis skills are superior to any medical provider. Randomly see that and autism self diagnosis becoming very popular.
 
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annoyedpsychiatrist said:
The number of people seeking stimulants seems to have certainly increased from when i started residency years ago to present day attending life. I get so many people who have decided they have ADHD and social media is definitely negatively influencing this. Ugh. And cant argue with them because they have decided their self diagnosis skills are superior to any medical provider. Randomly see that and autism self diagnosis becoming very popular.
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Yes. Everyone with a little normal depression thinks that stimulants are the answer. Getting an autism diagnosis means that your ****ty social skills and odd habits get normalized.
 
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annoyedpsychiatrist said:
The number of people seeking stimulants seems to have certainly increased from when i started residency years ago to present day attending life. I get so many people who have decided they have ADHD and social media is definitely negatively influencing this. Ugh. And cant argue with them because they have decided their self diagnosis skills are superior to any medical provider. Randomly see that and autism self diagnosis becoming very popular.
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Self-diagnosis, self-serve drive-thru model.

But, hey, this ain't [As]Burger King.
 
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Fan_of_Meehl said:
Self-diagnosis, self-serve drive-thru model.

But, hey, this ain't [As]Burger King.
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I mean, I have ADHD. I struggle with concentrating on reading academic material I have no interest in, but may eventually lead to a high paying job. I definitely need some Ritalin.
 
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Sanman said:
I mean, I have ADHD. I struggle with concentrating on reading academic material I have no interest in, but may eventually lead to a high paying job. I definitely need some Ritalin.
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Fine..."Have it your way!" [at Asperger King]

What will be really fascinating is when the unstoppable force of 'OMFG metrics! We have to get em in to clinic, cure them, and get em out! Scarcity-model' comes into full collision with the immovable object of 'patient's needs, preferences, and satisfaction ratings.'

I mean, it's a latent conflict (cold war, of sorts) playing out every single day in VA mental healthcare settings.

Every day.
 
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Sanman said:
I mean, I have ADHD. I struggle with concentrating on reading academic material I have no interest in, but may eventually lead to a high paying job. I definitely need some Ritalin.
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Same. Some day are better than others for me.

Fan_of_Meehl said:
Fine..."Have it your way!" [at Asperger King]

What will be really fascinating is when the unstoppable force of 'OMFG metrics! We have to get em in to clinic, cure them, and get em out! Scarcity-model' comes into full collision with the immovable object of 'patient's needs, preferences, and satisfaction ratings.'

I mean, it's a latent conflict (cold war, of sorts) playing out every single day in VA mental healthcare settings.

Every day.
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Indeed - I see my work at the VA like the pandemic (as it should have been viewed as 2 years ago), in that this is an endemic. We can't strive for 100% perfection, and must be okay with the fact that there will always be "pathology" out there. It changes how we frame the situation and ultimately, how we/I approach our work with patients. I am certainly not looking to cure all psychopathology in the world, nor spend a ton of time with advocacy groups on my spare time trying to better the world. I belong to like 2 organizations as a committee member and advocate for what I think should be advocated for, but even then, my interest in them is minimal and my engagement is enough to fulfill my roles as I also know working with a group of other psychologists who want to save the world is just a waste of cognitive resources for me.
 
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I almost miss when there was more of a stigma in regards to mental health, because now that its less stigmatized it has become cool to have a mental health diagnosis and barely noticeable symptoms have somehow evolved into major disorders that warrant aggressive treatment
 
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Yep, it seems we're almost at the point now (and probably have providers out there already with this view) that if a person believes they have a diagnosis/condition, we should just accept this, because hey, it's their lived reality and opinion, and who are we to question that.

It seems we're also only a small step away from apps/websites and providers that, instead of offering even a sham of an evaluation via a two-minute questionnaire, just give a list of conditions and say, "pick what you want."
 
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AcronymAllergy said:
Yep, it seems we're almost at the point now (and probably have providers out there already with this view) that if a person believes they have a diagnosis/condition, we should just accept this, because hey, it's their lived reality and opinion, and who are we to question that.

It seems we're also only a small step away from apps/websites and providers that, instead of offering even a sham of an evaluation via a two-minute questionnaire, just give a list of conditions and say, "pick what you want."
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I'm gonna go for DID so that I can explain away any crimes I commit ala Herschel Walker.
 
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Indeed - folks getting "triggered" etc. I like to pump the brakes on things before the newest fade or buzzwords erroneously become adopted as "truths." Like "micro" fill in the blank. So much variability and inconsistency in that line of research, yet, like with EMDR, people ran with it and accepted it as truth.
 
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annoyedpsychiatrist said:
The number of people seeking stimulants seems to have certainly increased from when i started residency years ago to present day attending life. I get so many people who have decided they have ADHD and social media is definitely negatively influencing this. Ugh. And cant argue with them because they have decided their self diagnosis skills are superior to any medical provider. Randomly see that and autism self diagnosis becoming very popular.
Click to expand...
I often wonder how many with an "autism" self-diagnosis actually have a personality disorder.
 
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annoyedpsychiatrist said:
all
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Probably many of them in my experience.

However, with kids, it is financial. Parents want their kids to have goodies and perks relative to school but not pay for them, so they enlist the help of a Psychologist to get the Autism diagnosis which will result in those goodies and perks being given for free. The parent will tell you ahead of time "I KNOW Johnny has autism because he has all the symptoms I read about on the internet".

If the kid really does have Autism, no problem. If the kid does not and you tell the parent that, all hell will break loose including board complaints, lawsuit threats, etc.

This is why I no longer see children when a parent says they are "worried" about Autism.
 
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msc545 said:
Probably many of them in my experience.

However, with kids, it is financial. Parents want their kids to have goodies and perks relative to school but not pay for them, so they enlist the help of a Psychologist to get the Autism diagnosis which will result in those goodies and perks being given for free. The parent will tell you ahead of time "I KNOW Johnny has autism because he has all the symptoms I read about on the internet".

If the kid really does have Autism, no problem. If the kid does not and you tell the parent that, all hell will break loose including board complaints, lawsuit threats, etc.

This is why I no longer see children when a parent says they are "worried" about Autism.
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I've never had this issue - but I start managing expectations early on so that the parents who are shopping dont waste their time. When I pull out my manilla folder to plan the assessment with them, I tell them what I am looking for. If there is a concern about ASD, I make sure to say "because ASD is a concern, I have to rule mental ******ation (because no one uses ID outside of our field). And it can also be X, Y, or Z or normality, which is why I only do comprehensive evals." If I am getting a non ASD vibe from the kiddo, I do say "it's unlikely they have ASD because of (insert comment about joint attention/sharing of affect/eye contact, social overatures, etc) but my opinion doesn't matter (it does lol) because the data is more important. My testing will catch ASD if it there 99 times out of a hundred. But, this is why test - to get good objective information." I might also spend two minutes talking about why we test and diagnose (describe whats going, identify strengths and challenges, to predict, and to influence or treat (and the tx of ASD is supremely different than say ADHD."

This will filter the asd shoppers usually.
 
borne_before said:
I've never had this issue - but I start managing expectations early on so that the parents who are shopping dont waste their time. When I pull out my manilla folder to plan the assessment with them, I tell them what I am looking for. If there is a concern about ASD, I make sure to say "because ASD is a concern, I have to rule mental ******ation (because no one uses ID outside of our field). And it can also be X, Y, or Z or normality, which is why I only do comprehensive evals." If I am getting a non ASD vibe from the kiddo, I do say "it's unlikely they have ASD because of (insert comment about joint attention/sharing of affect/eye contact, social overatures, etc) but my opinion doesn't matter (it does lol) because the data is more important. My testing will catch ASD if it there 99 times out of a hundred. But, this is why test - to get good objective information." I might also spend two minutes talking about why we test and diagnose (describe whats going, identify strengths and challenges, to predict, and to influence or treat (and the tx of ASD is supremely different than say ADHD."

This will filter the asd shoppers usually.
Click to expand...
Yes, there is a way to manage expectations in these situations, but I am not being paid for the extra time it takes, and I would rather not take the chance that what I did was effective, only to find out months later that they have complained. It is not worth the risk.
 
msc545 said:
Yes, there is a way to manage expectations in these situations, but I am not being paid for the extra time it takes, and I would rather not take the chance that what I did was effective, only to find out months later that they have complained. It is not worth the risk.
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I understand the need to be cautious, but there is little risk and it doesn't take much time to manage this stuff. I've never heard of a board complaint for autism. There was one in my state where an older psychologist seriously deviated from standardized testing procedures and appears to have missed a two year old. But, they were dinged more for deviating from standardization than the miss.
 
borne_before said:
I understand the need to be cautious, but there is little risk and it doesn't take much time to manage this stuff. I've never heard of a board complaint for autism. There was one in my state where an older psychologist seriously deviated from standardized testing procedures and appears to have missed a two year old. But, they were dinged more for deviating from standardization than the miss.
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At least with my colleagues I worked with doing forensic work back in Ohio, they told me "if you aren't getting at least one a year, you aren't doing your job right." lol
 
ohiopsychdoc said:
At least with my colleagues I worked with doing forensic work back in Ohio, they told me "if you aren't getting at least one a year, you aren't doing your job right." lol
Click to expand...

That was essentially the feel for neuropsych in the VA. If you weren't getting patient advocate complaints, it usually meant you weren't doing validity testing.
 
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borne_before said:
I understand the need to be cautious, but there is little risk and it doesn't take much time to manage this stuff. I've never heard of a board complaint for autism. There was one in my state where an older psychologist seriously deviated from standardized testing procedures and appears to have missed a two year old. But, they were dinged more for deviating from standardization than the miss.
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There have been plenty of these types of complaints in my state where we have a particularly strict board. It only takes one complaint to wreck your career.
 
msc545 said:
There have been plenty of these types of complaints in my state where we have a particularly strict board. It only takes one complaint to wreck your career.
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Complaints are irrelevant, board actions are what counts. Can you link to what board actions you are referring to as they are public record?
 
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WisNeuro said:
Complaints are irrelevant, board actions are what counts. Can you link to what board actions you are referring to as they are public record?
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Spoken like someone who is very comfy doing forensic/legal work. :rofl:
 
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WisNeuro said:
And also very aware of what boards will and will not take action against. Most people are needlessly worried about board complaints.
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I listen to every single board meeting, along with out complain screening committee. (Don't judge, I love some chisme and it's good background noise while I'm mowing and stuff). But here is basically the top three complaints that get forwarded to board: sex/multiple relationships, getting drawn into divorce, practicing while impaired/gross practicing outside of competency.
 
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borne_before said:
I listen to every single board meeting, along with out complain screening committee. (Don't judge, I love some chisme and it's good background noise while I'm mowing and stuff). But here is basically the top three complaints that get forwarded to board: sex/multiple relationships, getting drawn into divorce, practicing while impaired/gross practicing outside of competency.
Click to expand...

Yeah, those are the big ones, along with billing/documentation issues. We recently had someone billing Medicare for trainee work and not documenting. But yeah, I am skeptical of any claim of board actions from regular practice issues as stated above. I call BS unless you can show me the documented board action.
 
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To be fair, for those of us early career folks (wait, am I still early career at this point? I think I might be mid-career now), the idea of just a board complaint is still pretty scary. I don't even like patient advocate complaints--I know they mean that I'm doing my job, but it still stresses me out.
 
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cara susanna said:
To be fair, for those of us early career folks (wait, am I still early career at this point? I think I might be mid-career now), the idea of just a board complaint is still pretty scary. I don't even like patient advocate complaints--I know they mean that I'm doing my job, but it still stresses me out.
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I get that they can be scary, but it's no reason to completely change your practice, as long as you are practicing ethically and within the community standard of care, as some have suggested.
 
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