Focus

I recently returned from a two week vacation overseas. My travelling companions made up a dynamic that I had not been together with in many years. Without thinking about it, I slipped back into an outmoded way of being. As I’ve grown, and learned new ways of living in the world, I’ve moved past some of the less effective ways of my youth. However, sometimes I find myself in a situation where I feel or act in a way I haven’t for a long time. Is that something you can relate to at all, dear reader? When removed from a situation that is uncomfortable, we often find adaptive ways of preventing similar situations in the future. Other times, we turn a blind eye to how things were, and may end up coming across the same obstacles we haven’t yet surmounted.

Upon returning home, I was exhausted. I was jet-lagged, I hadn’t been sleeping well, and I was getting over a sinus infection that had kicked my butt. Standing in my living room, I reflected on the trip. I recognized that having an awareness of my style of life would aid me in accepting, and ultimately forgiving the person that I was. By feeling compassion for ourselves, we are able to recognize that we are doing the best that we can with the resources we believe are available to us. By recognizing and gaining awareness of our actions, it frees us up to choose differently in the future.

I spent time in quiet reflection, and in expressing myself to my partner. Having someone to listen, acknowledge, and reflect my thoughts was incredibly validating. I found the forgiveness for self that I was looking for. Once released, I found a quiet spot and wondered: now what? I understand where I’ve been, now where am I going? What do I want? Why am I here?

It’s easy to let life live me, it takes conscious effort to live an intentional life. I would like to identify what it is that I want out of life, and why it is that I’m here. Once I’ve figured that out, I’d like to feel what it would feel like to accomplish those goals. Following the feeling of accomplishment, I would like to release any sense of need or attachment to those successes. This will aid me in creating a motivated, creative environment with which to move towards my goals. In that environment, a nonattached style of living will aid me in feeling content with whether or not those goals come to be. Either way, I am moving in the direction of what I want in life, focused on the journey and not the destination.

“Where the world like a loose garment. Don’t ignore it, and don’t let it dominate you.”

“The dark night of the soul is the evolution of one’s spirit.”

“Be towards the world the way you would want it to be towards you.”

Here’s what I came up with:

Wishing you the ability to choose your greatest good!

JP

Advertisements
Posted in Health and Well-Being, Psychology, Uncategorized | Tagged , , , , , , , , , , , , | Leave a comment

A Developing Counselor’s View on Laws and Ethics

Abstract

The purpose of this paper is to deepen my understanding of the connection between the ethical and legal considerations in regards to mental health counseling. As a new counselor it is my desire to use the codes of ethics as well as current laws to develop a framework with which to grow my skills as a counselor. Because of the need for skill and precision in what we do as counselors, there are many laws that have been put in place to hold us accountable for our actions. I have found that the codes of ethics contain within them the laws which we uphold, as well as expand upon what our role is as an ideal. While not everything within the codes of ethics is also law, we can view ethics as the playing field, and the law as the boundary line within which we operate.

A Developing Counselor’s View on Laws and Ethics

This is my first semester in the LMHC program. Coming in, I did not have a firm grasp on what it was counselors did. The process of knowing what to say, having a plan, and ethically aiding a person is still daunting to me. The therapeutic relationship often involves a person being open and honest in ways that they are with no one else in their life. The importance of morally and ethically navigating these relationships is paramount to the success of a counselor. While initially intimidating, the number of laws and the codes of ethics now form a backbone of my understanding of how to interact with clients in session and out. It seems to me that the metaphor of a playing field could be used in describing the relationship between the ethics and laws. We can see the boundary lines of the playing field as the laws, and the playing field itself as the moral and ethical ways in which we behave as counselors. I would like to further grow my knowledge of how best to navigate this counseling field. A deep understanding of the similarities and differences between the laws and ethics will aid me in doing what is best for the clients I have. We will begin this discussion by looking at laws that apply to us here in New York. From there, we will branch out and have a look at the acts that ensure individuals rights are upheld in a variety of situations. The ACA, and AMHCA, codes of ethics will be used to compare and contrast these documents. We will conclude by summarizing the connection between the ethics and laws that are present.

Starting at the beginning in the American Counseling Association (ACA) code of ethics, A.1.a. states that the primary responsibility that we have as counselors is to respect the dignity, and promote the welfare of the clients under our care (American Counseling Association, 2014). The American Mental Health Counselors Association (AMHCA) similarly states that a counselor’s prime directive is to have respect for a client’s autonomy, dignity, and to promote that person’s welfare (AMHCA, 2015). We can see that here in NYS there are laws in place that uphold this core responsibility. A part of the NYS Mental Hygiene Law describes how when a person is admitted to a psychiatric center, they retain all of their civil rights. They are to be protected from any abuse or mistreatment within that center that might come from other residents, or from the staff. The personal rights that are required within these centers extends to the provision of clothing, the food that is provided, and that the environment is kept sanitary (Office of Mental Health, n.d.). We can begin to see how the laws that govern uphold the ethics that we follow. In this way we are all held to a high standard of providing care to those who may be having difficulty caring for themselves. Perhaps a more direct connection between this aspect of the Mental Hygiene Law and what we provide as counselors would be in regards to confidentiality and privacy. Looking at B.1.b. and B.1.c. within the ACA, a client is given respect for privacy and confidentiality. It states that we are only to ask for private information from a client when it is believed to be beneficial to the therapeutic process. Similarly, counselors are only to disclose information when there is ethical justification for doing so (American Counseling Association, 2014). I.A.2. of the AMHCA is where we find the discussion of confidentiality. It discusses how keeping information about clients safe is a primary duty. The wording here is slightly different, as information is communicated to others only with the client’s consent, or when dictated by state law (AMHCA, 2015). These codes hold true legally when we look at the Mental Hygiene Law. The Office of Mental Health is required to provide a Notice of Privacy Practices, which states that generally no information may be given out without a patient’s written permission (Office of Mental Health, n.d.).

The case of personal rights is very clear cut. Privacy and confidentiality rules held true across both codes of ethics, as well as state law. This right and wrong way of viewing things is not always the case. Within the profession of counseling, there are many grey areas where the correct answer is not always so apparent. One example of this ambiguity would be in disclosure of the communicable disease HIV. If we look at the ACA, B.2.c. describes how in some cases it may be ethically appropriate to disclose that someone has an infectious condition (American Counseling Association, 2014). If a client has serious intentions of having sexual contact with someone, and would infect that person with a potentially fatal disease as a result, there may be good cause for disclosing to the third party. This is where the situation becomes complicated. As counselors, it is our highest priority to work in the best interest of the client. In this case, that would mean attempting to work with the client towards their realization of the negative impact of infecting the third party with a harmful disease. If the client makes their intent to act anyways known, ethically it may be correct to warn the person before damage is done. This is not the case in New York, however. Within our state, there is Public Health Law, Article 27-F, which protects the privacy and confidentiality of anyone who has been tested for, exposed to, been treated for, or has HIV or an AIDS related illness (New York State Confidentiality Law and HIV: Questions and Answers, n.d.). Both the ACA and the AMHCA contain statements that above all else a counselor should comply with state and federal statutes concerning mandated reporting (AMHCA, 2015). This is an interesting case of ethics and the law diverging from each other. While it may seem that the most correct thing to do may be to speak up and warn the person in question, legally that is not the case. After discussion, I believe that the most correct course of action would be to communicate with the client the dangers of what they are thinking. Through effective counseling it may be possible to show them alternatives to not communicating their condition.

With the vastness of topics the counseling field contains, it makes sense that morally grey areas would present themselves. Upon entering this program, my most anxiety-inducing questions all pertained to these grey areas. There seemed to be many topics that could catch a counselor off guard. As the semester has gone on, I have found a sense of confidence as a result of learning about ethical decision making models. An article entitled Privileged Communication Between a Patient and Clinician discusses a morally grey area where we may use such a model. In this case, a patient suffering from schizophrenia was admitted to a behavioral care facility for experiencing auditory hallucinations telling him to kill himself. The psychiatrist that treated him filed a petition for the patients continued residency after learning that he planned to kill himself. The patient attempted to have the petition thrown out, saying that he was not informed that what he said to the doctor may be used in legal proceedings. The judge presiding over the case ruled in favor of the doctor, after determining that the privileged communication was overcome because of the threat of imminent harm (Sarathy & West, 2015). The psychiatrist in this scenario decided to act after learning of the patient’s intent to inflict harm upon himself. How did he decide to speak up and take action in this circumstance? In the HIV situation, the most ethical thing to do was to attempt to work together with the client and aid them in finding a different solution than infecting their partner. In the situation involving the suicidal patient, speaking out and petitioning for more treatment time was seen both ethically and legally as most correct. This decision is made more easily when looked at through the context of an ethical decision making model. Corey, Corey, and Callahan (2015) presented a model that has stayed with me, and has eight steps to consider. Instead of going through each step, I will point out a couple of important points. There are several models for ethical situations, some for specific situations; what they have in common is that they require the counselor to pause and break down a problem into parts. By looking at the situation in a structured way, one can be sure that an informed decision will be reached. I have learned that if something doesn’t feel right in session, it is correct to run through the steps of a model to see what comes up. Identifying the problem or issue provides direction, reviewing ethical codes focuses a counselor on providing the best care possible, seeking supervision provides context from those who may have insight upon the situation (Sheperis, Henning, & Kocet, 2016). Having these tools at my disposal makes me feel more confident moving forward.

Another tool we as counselors use are records and documentation. In regards to ethical decision making, it is important that a counselor keep a record of the process they went through to arrive at the decision they did. This could possibly aid a counselor if they were to be court-ordered, or asked to elaborate upon their decision making process. The ACA, under section B.6.a. requires that a counselor create and maintain the records and documents that are needed for providing professional services. Section B.6.b. discusses how these records must be kept secure, and that only those who are authorized have any access to them (American Counseling Association, 2014). The AMHCA ethics code follows suit under 2.i. stating that counseling records must be maintained under conditions of security, and that they must be destroyed after five years of cessation of treatment (AMHCA, 2015). So important are privacy considerations that a federal law was introduced in 1996 to create a uniform level of security among healthcare records. Prior to its introduction, laws were made by state and differed upon where a person was within the country (Wheeler & Bertram, 2015). HIPAA has since been reformed so that it now covers both paper and electronic documents that pertain to a patient’s healthcare records. On the educational side of document confidentiality, FERPA is an act that retains student privacy. The Family Educational Rights and Privacy Act, also known as the Buckley Amendment, was created in 1974 in order to maintain privacy and accuracy of educational documents and records. While the importance of privacy at that time was no less valid, the invention of the internet has created even more need for security and privacy of this information. Educational records may contain a student’s place of birth, information about their parents and family life, grades, any disabilities they are experiencing, as well as medical records (Toglia, 2017).

While privacy and confidentiality are a cornerstone by which we as counselors practice, there are some instances in which we are required to disclose information about the clients we see. A situation like this is called mandated reporting, and is required by law in some instances (Welcome, n.d.). An example may be a case in which a juvenile in counseling reveals that they have had sex with someone who is older than they are. Age of consent laws vary to a small degree by state. In New York, the age of consent is seventeen. This is the age at which a person is recognized as being legally old enough to consent to sexual activity. If a counselor learns that a child under the age of seventeen is being taken advantage of, it would be ethically correct to discuss the illegality of this with them. The counselor would need to be attentive to how the client feels about the situation, and to communicate to them the ethical obligations that they are bound by. The key here would be to work together with the client, and to discuss with them before making any action. Looking at the ACA code A.2.d., we see that when counseling minors we must seek their assent (approval), and to balance including them in the decision making process with our ethical obligations (Sheperis, Henning, & Kocet, 2016).

I believe that counseling is a service that should be made available to all those who seek it out. This profession is non-discriminatory, culturally sensitive, and inclusive of all peoples. It reminds me of the preamble at the start of the U.S. Constitution. “We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America” (Convention, 1787). Phew! A long winded sentiment, but one that applies to the high ideal we reach for as counselors in a position to help.  This can and does include those individuals who are living with disabilities. Because of the possibility that those who have difficulty speaking for themselves will be taken advantage of, there are both ethical rules and laws that are in place. Looking at the ACA code, we can see subject A.2.c. concerning developmental and cultural sensitivity. This item describes the importance of a counselor communicating information in a way that is both developmentally and culturally understandable, to the best of our ability. It is on us as counselors to adjust our practices to accommodate these individuals. Further, A.2.d. discusses how when counseling minors, or adults who are incapacitated, a counselor receives their assent (or approval) and includes them in the decision making process (American Counseling Association, 2014). The AMHCA does not single out those with disabilities in its code, however the code itself is openly worded to include those with disabilities. Under I.B.1., the AMHCA discusses how the counselor and client must work together to create an integrated, individualized plan that makes a reasonable promise of success, and is consistent with the abilities of the client (AMHCA, 2015). It is important that we as counselors be familiar with the ADA, or the Americans with Disabilities Act. Created in 1990, and amended in 2008, the ADA is a civil rights law that prohibits any discrimination against those with disabilities in public areas; this includes jobs, educational institutions, and all “public and private places that are open to the general public” (What is the Americans with Disabilities Act (ADA)?, n.d.). A counseling practice with 15 or more employees may want to seek legal advice in regards to hiring those with disabilities. It is a necessary and altruistic service to provide employment to those who require reasonable accommodation. Providing accommodation extends to the services counselors offer as well. It may be necessary to alter a counseling practice in small ways in order to accommodate someone who is experiencing a disability. An example of this may be a larger font on an informed consent form for someone with limited vision, or a wheelchair access ramp for someone who has lost the use of their legs (Wheeler & Bertram, 2015). Considering the scope of the service that counseling provides, these accommodations seem a natural fit for this profession.

Continuing in the direction of accommodation, the Individuals with Disabilities Education Act (IDEA) is a law that works with children who have disabilities in the public school setting. IDEA controls how both states and agencies administer early intervention, special education, and other services to the youths of America. The act also makes available formula grants (to support special education and early intervention) and discretionary grants (to support research, demonstrations, assistance, development, and parent training and information centers) (About IDEA, n.d.). Working together IDEA, Section 504 is a part of the Rehabilitation act of 1973. This act prohibits any discrimination a student might endure as a result of a disability. It is a civil rights statute that makes sure the needs of these students are met to the same degree as students who do not have disabilities. “No otherwise qualified individual with a disability in the Unites States, as defined in section 706(8) of this title, shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance” (Durheim, 2017). Lastly, on December 10, 2015 president Obama signed the Every Student Succeeds Act into law. This was a newer version of what used to be called the No Child Left Behind Act, from 2002. This revitalization of the school system put many changes into place that benefitted students. Protections were put into place for the countries disadvantaged and high-need students. It put into place an expectation that there will be positive growth in the lowest performing schools. It also requires, for the first time, that all the students in the country be taught to high academic standards that help aid them in success in college (Every Student Succeeds Act (ESSA), n.d.). It is interesting and important to note the connection between these acts and the codes of ethics that we adhere to as counselors. In our profession we are concerned most primarily with promoting our client’s well-being. Our goal is for them to reach higher levels of functioning and life satisfaction. It is heartening to see that the ethics by which we practice have been implemented to a degree into the laws that govern our country (and our youths!). While the major codes of ethics may create some grey area with laws that are in place, there are far more circumstances it would seem where the two complement each other.

While it may have been intimidating to begin this course with little knowledge of ethics, I feel increasingly confident that the knowledge of the different codes and the law will aid me in making the right decisions. I plan on always putting the client’s well-being first, and to openly communicate with them about the direction we are headed in. I can see the importance of keeping organized notes on the sessions I participate in, and of the need for vigilance in keeping all documents classified. The most intimidating aspect of counseling I identified at the start was the ethical dilemmas I couldn’t see a way of handling. With knowledge of several ethical decision making models I feel much more confident that I can level-headedly approach complex problems, and come up with a solution that most benefits the client (while adhering to ethics and state laws, as well). I’m excited to be taking this class my first semester in the program, as it has given me a feeling of confidence to handle unique situations. I’m looking forward to expanding upon my knowledge of ethics, and using them to benefit the clients that I come into session with in practicum. I’ll be sure to stay within the boundary lines of the field!

 

References

About IDEA. (n.d.). Retrieved from U.S. Department of Education: https://sites.ed.gov/idea/about-idea/

Association, A. C. (2014). 2014 ACA Code of Ethics. Alexandria: American Counseling Association.

Association, A. M. (2015). AMHCA Code of Ethics. Alexandria: American Mental Health Counselor’s Association.

Convention, P. (1787, September 17). U.S. Constitution. Philadelphia , Pennsylvania, United States of America.

Durheim, M. (2017, November 3). A paren’ts guide to Section 504 in public schools. Retrieved from Great! Schools: https://www.greatschools.org/gk/articles/section-504-2/

Every Student Succeeds Act (ESSA). (n.d.). Retrieved from U.S. Department of Education.

New York State Confidentiality Law and HIV: Questions and Answers. (n.d.). Retrieved from Ny.gov: https://www.health.ny.gov/diseases/aids/consumers/testing/confidentiality_law.htm

Office of Mental Health. (n.d.). Retrieved from Ny.gov: https://www.omh.ny.gov/omhweb/patientrights/inpatient_rts.htm

Sarathy, S., & West, S. (2015). Privileged Communication Between a Patient and Clinician. Journal of the American Academy of Psychiatry and the Law Online, 529-531.

Sheperis, D. S., Henning, S. L., & Kocet, M. M. (2016). Ethical Decision Making for the 21st Century Counselor. Thousand Oaks: SAGE Publications.

Toglia, T. V. (2017). How does FERPA affect you? Tech Directions, 21-25.

Welcome. (n.d.). Retrieved from Mandated Reporter Resource Center : http://www.nysmandatedreporter.org/Welcome.aspx

What is the Americans with Disabilities Act (ADA)? (n.d.). Retrieved from ADA National Network: https://adata.org/learn-about-ada

Wheeler, A., & Bertram, B. (2015). The Counselor and the Law. Alexandria: American Counseling Association.

 

 

Posted in Psychology | Tagged , , , , , , , , , , , | Leave a comment

Developmental Reflection

Sitting on my bed, I began to prepare for what was to become this reflection paper. I had the textbook, a notebook, and a leather-bound photo album that smelled like the bottom of my mom’s purse. I intended to use this album to help me remember some of my earliest memories. It worked, to a degree! I don’t remember anything before the age of about three. What happens then is a hazy collection of near-to-the-ground images that coalesce to form an idea of what toddler Joe was like. Conversations with my mother also helped me put things together. From there, the memories came more easily; gelling together in a way the earlier ones did not. Assigning the memories that came up to developmental tasks and theory was the next step. I will begin this reflection at the age of three, when locomotion aided me in escaping from robotic dinosaurs, and we will end up with ten year old me having developed a sense of competence while tinkering with my dad’s Power Macintosh computer.

I was born in Texas, and lived in a dry, arid, flat space until the age of five. My earliest memory that I could come up with was standing in my family’s backyard and feeling small looking out at the vast desert that lay in front of me. Upon visiting as an adult, I learned that it was a fenced in space that would take approximately thirty minutes to mow. I began walking in this space, aided by the freedom of not wearing diapers. I can see that my psychosocial development was aided by my ability to have a slew of new interactions with my environment now that I could move from room to room, and from play to caregiver. My mother told me that she remembered my playing with planes, and the noises I would make as I would walk along with my hand outstretched. These locomotor skills made it possible for me to develop new ways of play that I was not capable of before. Dynamic systems theory applies to my view of how I was growing. My arms and legs were becoming more muscular and able to carry my weight more efficiently. My central nervous system was developing, which aided in my coordination. I was also getting lots of practice! My parents took me to a science center during this time. There was an exhibit featuring animatronic dinosaurs that I expressed interest in. My mother brought me close to one of the dinosaurs that wasn’t moving, and let me walk near it. It jolted to life, turned its head and roared! I used all of the locomotion I could muster to gallop away from that dinosaur. A landmark moment in coordinating all of my developing motor skills.

As I grew and moved about more freely, I was also developing in my abilities to think and speak. Semiotic thinking refers to a developing child’s ability to understand symbols. This, coupled with my newfound motor skills aided me in imaginative play. At the age of four I was constructing castles out of couch cushions, vast cave networks, and escape routes. I used pillows, sheets, and broom handles to serve as building materials. This representational thinking would continue to develop as I grew. My younger sister began to partake with me in play time. Being two years younger than me, she didn’t participate as much; but I included her in the stories I was creating just the same. I would assign her tasks and duties within the castle, and make sure she knew her way around. These representational skills were important for me to be able to share the experience with her (even if she wasn’t quite that far along developmentally). My mother related to me that I would rattle off about various goings on during our play, some of which made sense and some that did not. Often times she would engage me in conversation as I was playing. When she noticed that I was using the wrong word, she would give me a different one. Sometimes she would give me simple reflections to show me that she understood what I was talking about. This was great practice for me to continue learning our language. What she was doing was exhibiting verbal scaffolding, which helped me to more easily reach higher levels of language skill.

I was surprised to learn that between the ages of three and four I was difficult to get along with! Years later I would fill the role of mediator, and would avoid conflict and disagreements at all costs. However, during the psychosocial crisis of autonomy versus shame and doubt I could be cross, seemingly selfish, and would disagree with what my parents had to say. My mother expressed exasperation at my need to use the bathroom by myself, and for her not to watch as I did so. This yielded mixed results, and further frustration on my mother’s part as she would have to clean up after me on a couple of occasions. I began taking ownership for household objects, interestingly. Often I would take something, a drink coaster at one time, and run off with it. This behavior did pay into a negative event for me that would impact my self-concept and family relationships. One summer afternoon my family was outside in our front yard. We had neighbors over, and everyone was milling about, conversing, and getting ready for a barbeque. A few of the older kids were playing with a ball, and I ran over and snatched it. As was my habit, I ran away with the ball; except this time I ran towards the street. There was a car coming towards me, and my father yelled for me to stop. I did, petrified at his tone, and he ran over and scolded me. I don’t remember being aware of all the people that were watching as this happened, but I do have a sense of the frustration and humiliation that came up while it was happening. In that moment I felt shame, and did not understand why he was so mad at me. That experience would stay with me, and pay heavily into how I viewed and interacted with my father moving forward.

My family moved around a lot when I was little. My father worked as a school principal, and we moved from Texas to Maryland when I was five. Upon arriving in Rockville, MD, I began kindergarten and started socializing with a group outside of my family for the first time that I can remember. An interesting event stood out to me about a year later in first grade. There was a girl in my class named Sarah. Sarah was very vocal, athletic, a little rough, and dressed like a boy. One day in class Sarah came up in conversation, and I said that “he was playing with…” in reference to an activity we had done. The teacher corrected me in saying that Sarah was a girl. I remember the slight confusion and embarrassment at incorrectly stating a person’s sex. This was my first experience with a person’s gender identification, and that not all boys enjoy traditional masculine activities, and that not all girls enjoy regular feminine activities. My incorrect thoughts about a gender label at this time made me more aware of the differences between people, I believe. Sarah and I played on the same basketball team, and knew each other for years after that. My own gender identification came as I understood increasingly the concept of gender, and the differences between man and woman. As I continued to grow I identified and aligned with what was masculine, except in some ways with my father. There was a disconnect between us, and I identified far more with the empathic and kind methods of my mother. Being stoic, stern, and rigid did not seem appealing to me. This rift in parental identification put some strain on our relationship. He and I had a couple of formative conversations of what he believed to be the correct way of being in the world. Now that I’m grown, I’m able to take what he said that I agree with and add it to my worldview. At the time, I disagreed and opposed his viewpoint.

First grade was a time full of memories for me; more so than second or third grade. My teacher’s name was Mrs. King (easily recalled), I had several friends, and we were loud, boisterous, and full of initiative. My first memories of being immersed in nature come from this age as well. My neighborhood friends and I would explore Rock Creek Park, which was at the end of my road. Pulling from the sense of independence and autonomy I had felt earlier, I investigated the woods and creek with much joy. We would turn over rocks, and discover crawfish, salamanders, and all sorts of bugs. We built small boats out of paper and hollowed out bark to float down the creek. We developed social competence by positively interacting with each other, forming bonds, and being aware of how the others in our group felt. I became more vocal in school, and started wanting to feel like a leader, or like someone who was in charge. This feeling perhaps arose from a misidentification with my dad. I did feel some amount of guilt during this time. Not being close with my father made me feel like I had done something wrong. I did not understand why things were that way at the time, and my behavior showed signs of someone out to prove that he was worthy of a father’s affection. This behavior may have been my mirroring my perceived idea of how he was in the world. This would show my attempt at identification with him. The fear of the loss of love would contribute in this way as I tried to behave like him in order to establish a positive relationship. My identification with the aggressor also makes sense as my behavior mimicked in some ways those of the parent who I felt fearful of. My mother, in contrast, was an exuberant and energetic person. My ideal self-image contained aspects of her positivity, and I moved towards this ego ideal that I held by moving in the direction of the things that made me feel spirited and lively. Mostly, this included spending time with friends in nature.

At the age of ten my family moved again, this time to Amherst, Massachusetts. I left behind the friend group that I had made, and was immersed in a completely new social setting. I was sad to leave my friends, and wanted to have that feeling of inclusion again. I worked hard to make friends in this setting, and displayed social competence by joining a group of kids in my new neighborhood. I sought to fit in with this group of kids, and my desire for peer approval was shown in the way that I conformed to the way that they were. They had an interest in skateboards and mountain bikes, and I was thankful that my parents provided me with both. Although skateboarding has a rebellious connotation, I was straight-laced and did not act out. I had developed a relatively positive relationship with my father that was based on rules and actions. My use of rules and the more logical way of thinking I had during this time is characteristic of concrete operational thought. My dad brought home a computer in this time, and I was fascinated by this piece of technological wizardry. I remember that it was a Power Macintosh, and that it looked like an object from a Star Wars movie. As long as I behaved myself, I was allowed to tinker with it, and explore the operating system it was built on. Although realistically I was a novice typing away on it, I felt like an expert in no time. The computer was built on logical rules that carried over to its many processes. I developed computer skills by combining my knowledge about how it worked, and practicing those skills by using different programs. I felt a sense of competence as a result of learning about the computer. I became quite dexterous with the machine, and used it to word process and play a couple of games. This internalized sense of ability made me feel great, and soon all I wanted to do was play on the computer, or on the Sega Genesis hooked up to the TV in the living room. My friends also became interested in electronics, and soon we spent less time outside and more on the couch or seated at a desk.

My development from my earliest memories until the introduction of computers and electronics has had a strong influence on my thoughts about parenting. I now have a ten year old son of my own. I find that he has followed a similar path with an early exposure to nature, and a middle-childhood interest in electronics. Around the time that he was five, I rediscovered my love for the outdoors. I like to try and find a balance between exploration and adventure, and the enjoyment of technology. I get excited that he enjoys both, and is willing to turn off the TV and go for a hike. Both activities are ones that we can enjoy together, which satisfies my desire to do things differently than how my father did them. As we have aged, he and I have remained distant from each other. I have a deeper understanding of the experiences he has had that led him to where he is, and I have expressed myself to him in meaningful ways so that he can see who I truly am. I’m thankful for the opportunity to write about this, as the reflection makes me think about my own development in new and interesting ways. I look forward to what comes next!

Posted in Uncategorized | Tagged , , , , , , , , | Leave a comment

Love, thanks

I’d like to
Express
How much love
Thanks
I wouldn’t be
If it weren’t
For all it took
Here and there
I think of
How it was!
I take that
Forward and
Express
How much love
Thanks

OLYMPUS DIGITAL CAMERA

Posted in Uncategorized | Leave a comment

Person-Centered and Reality Therapy

Person-centered therapy puts great emphasis upon the relationship between the therapist and the client. Carl Rogers himself theorized that the necessary conditions for change depended upon the quality of the relationship between therapist and client. This is accomplished in therapy through the therapist presenting themselves as being genuine, or congruent (Corey, 2013). The next way the therapy is applied is through a therapist’s unconditional positive regard for the client. By showing the client that they legitimately care about their well-being, the relationship deepens. There are no judgments placed upon the client; it is important that the therapist accepts the client just as they are. The greater the level of care and accepting between these two people, the greater the chance that the therapy will be successful. Another aspect of the process is to accurately understand the client’s experiences and feelings as they are related to the therapist. The point of this is to get the client to feel closer to themselves, in the hope that they will be able to recognize and do something about the incongruities they identify (Corey, 2013). There are no techniques in particular for this form of therapy; what is of greatest importance is that the therapist remains engaged deeply with the client, and that they feel as safe and well-regarded as possible in their attempts at undoing the incongruity that they are experiencing (Corey, 2013). This form of therapy is certainly a positive approach to managing crisis in a client’s lives. The unconditional positive regard that a therapist shows for a client may be above and beyond the kindness shown in any of their other relationships. In this environment a client should feel completely free to express, recognize, understand, and to work towards resolving the blockages in their life.

            The key concepts of reality therapy include its view of human nature. Reality therapy states that we are not born “blank slates” that are impressed upon by the world (Corey, 2013, p. 336). Instead, we are born with five needs that motivate our lives. These needs are survival, love and belonging, power, freedom, and fun (Corey, 2013). Of these needs, to love and feel a sense of belonging are of prime importance. Generally, people who enter reality therapy have no one to relate to, or have great difficulty relating to the people who are in their lives (Corey, 2013). Choice theory is central to the workings of reality therapy. Choice theory states that what we do in life is behave, and that the vast majority of the time what we do is chosen. Total behavior is a component of choice theory that tells us all behavior is made from four parts: acting, thinking, feeling, and physiology. When talking about symptoms, choice theory would say it would be more accurate to describe someone as depressing, rather than being depressed. This switches a client from being passive to active in their role of experiencing (Corey, 2013). Reality therapy focuses on poor relationships, or the absence of a relationship, within a client’s life. The therapist would ask the client to reflect on how their choices of behavior may affect their relationships. The emphasis here is on what the client can, in fact, control themselves: their behavior. By emphasizing choice and responsibility, a client is made aware that they are the one in charge of how they act. By changing these behaviors a client will learn that the consequences also change. Differing from therapies such as psychoanalysis, reality therapists act as themselves within therapy, and reject the idea of transference (Corey, 2013). All of this works to empower the client to understand their behavior, and to choose to make different decisions in the future. Reality therapy would certainly be applicable in a multicultural approach. The therapist shows respect for the client by aiding them in figuring out how well their current behavior is working for them and the people they are in relation with. The therapist is not telling the client how their behavior is or is not beneficial, but instead they are leading them to make their own conclusions about what their behavior is bringing them.

References

Corey, G. (2013). Clinical and Counseling Psychology. Mason: Cengage.

DSC02289

Posted in Uncategorized | Leave a comment

Anxiety and Children: Causation and Treatment

Anxiety is a feeling that is experienced throughout the life cycle. The well-adjusted individual will come upon anxiety, and work to alleviate the feeling; hopefully, learning something in the process and creating the ability to avoid a similar situation in the future. Unfortunately, childhood anxiety is a real problem that is commonplace in today’s society (Butcher, Hooley, & Mineka, 2014). A child who experiences a traumatic event, abuse, or perhaps a scary situation may become predisposed to developing an anxiety disorder that could last as they learn and develop. Children who develop these disorders are seen to have more serious versions of anxiety disorders than older individuals. As opposed to a child who experiences a regular amount of anxiety, and adjusts, a child who has developed an anxiety disorder exhibits specific traits. These negative traits include being irregularly timid and irritable, overly shy in front of people, fearful of new situations, they sleep poorly, and often feel as though they are not good enough in their endeavors. A child with a high amount of anxiety often learns to cope with these feelings by becoming overly reliant on parents and family for support (Butcher, Hooley, & Mineka, 2014). Experiencing these emotions this early in life may cause a condition that, if not dealt with, could cause problems throughout the formative years and into adulthood. It is of great importance that causal factors are identified, and corrective treatment paths are laid out to support these youths.

The most common form of childhood anxiety takes the form of separation anxiety (Butcher, Hooley, & Mineka, 2014). Past health studies have shown it occurring in rates between 2 and 41 percent of children studied. Traits that children experiencing separation anxiety exhibit are similar to those of the other anxiety disorders, as well as a focus on a lack of self-confidence, apprehension, and a tendency to immature for their age. They feel easily discouraged, worry excessively, and cry comparatively easy to others their age. Anxiety over detachment from major figures in their lives is the essential feature of this disorder. Many times, a stressor from the child’s past is seen to trigger the disorder: such as the death of someone who was close to them, or a beloved pet. When actually separated from the figures in their lives, these children become distracted by thoughts of their parents becoming ill, or dying. Children who experience separation anxiety as a disorder often go on to developing other anxiety disorders if not treated effectively (Butcher, Hooley, & Mineka, 2014).

Factors that cause anxiety disorders to arise during childhood have been studied and identified. Genetic predispositions are thought to be one cause, as well as social and cultural factors. An example of this would be a study by Potochnick and Perreira (2010) that found immigrant Latino youths were at a higher risk for anxiety and depressive disorders. Many studies have focused on the influence of parenting types, family stress, and belonging to a minority family as factors for the causation of anxiety disorders in youths (Butcher, Hooley, & Mineka, 2014). Children suffering from anxiety disorders will often become highly sensitive, which will make reacting negatively to situations an increasingly common affair. As a result, they may become more upset, more frequently, by small disappointments. As this process continues, a child may find it increasingly difficult to calm down, compounding the problem. Overly anxious children also show a modeling effect of a parent who is overanxious and protective. By sensitizing a child to perceived dangers and threats in the world, a parent may show a lack of confidence in a child’s ability to handle themselves; this may act to reinforce a child’s belief in their own inadequacy (Butcher, Hooley, & Mineka, 2014).

Although chronic anxiety does in some cases progress later into life, causing maladaptive disorders, typically it does not. One cause of the alleviation is more and varied experiences in social settings such as school. When a child begins to make friends and succeed at tasks that they are given, their self-concept and esteem improves. Teachers who are aware of children who are struggling with anxiety can also play a beneficial role by aiding them in having successful experiences that aid in alleviating anxiety. In addition to this, there are also biological and psychological treatments that are available for children (Butcher, Hooley, & Mineka, 2014).

Psychopharmacological is a big word for drugs for mental disorders. These drugs are becoming more widely used for treating anxiety in children than they have in the past. Using these drugs is a delicate decision, as the symptoms of anxiety disorders also arise in other disorders, of which medication would not be the correct solution. A careful diagnosis is required to ensure that these drugs are correctly implemented. It is this writer’s opinion that drugs not be used to treat anxiety in children, and that psychological treatment is instead used.

Behavior therapy is another treatment that is available, and is often put into use in school settings. These therapies often include assertiveness training, which help in learning beneficial coping strategies and desensitizing them to their anxious behaviors. Positive reinforcement is seen to provide a benefit to children in learning to cope with their fears. Behavioral treatment for children is best used on a case by case basis. The use of real-life situations has been shown to be more effective a treatment than having a child imagine a situation (Butcher, Hooley, & Mineka, 2014). The use of cognitive behavior therapies has also been shown to reduce anxiety in youths. By teaching children about how to identify the feelings they are experiencing, and beneficial ways to deal with them, marked improvements have been made in children experiencing elevated levels of anxiety (Butcher, Hooley, & Mineka, 2014).

One other interesting therapy approach is what’s called the FRIENDS program for preschool-aged children (4-7 years). This program addresses five areas of social and emotional learning: 1) developing a sense of self, 2) social skills, 3) self-regulation, 4) responsibility for others, and 5) prosocial behavior (Barrett, Fisak, & Cooper, 2015). This system goes above and beyond what traditional cognitive therapy has focused on. As opposed to focusing primarily on strategies that reduce current symptoms, the FRIENDS program has a dual focus. While working to reduce current symptomology it also promotes protective factors to prevent the onset and progression of any future disorders; this is done with a focus on resilience and well-being. In a study of 31 children diagnosed with an anxiety disorder, a study done by Barrett, Fisak, and Cooper (2015) showed a significant decrease in anxiety and shyness, and improved resiliency, as a result of completion of the treatment.

There will be events in children’s lives that will cause anxiety, there is no preventing that. By attempting to shield one’s child from the world may only make matters worse, possibly creating a separation anxiety disorder. Although these events mat transpire, there are methods available to aid in the development of resilient coping techniques. Cognitive therapy has been the go-to treatment in child anxiety treatment, and a new program entitled FRIENDS is now being shown to be even more effective. By facing life’s challenges alongside their children, parents and teachers alike are capable of aiding in the creation of beneficial outcomes to alleviate the pain, fear, and discomfort caused by a child experiencing an anxiety disorder.

 

References

Barrett, P., Fisak, B., & Cooper, M. (2015). The treatment of anxiety in young children: results of an open trial of the fun FRIENDS program. Behaviour Change, 231-242.

Butcher, J. N., Hooley, J. M., & Mineka, S. (2014). Abnormal Psychology. Upper Saddle River: Pearson.

 

IMG_1976

 

Posted in Uncategorized | Leave a comment

Simple Tools of Great Value

A member of the American Psychological Association (APA) and a psychiatrist for fifty years, David Hawkins was also a world-renowned researcher into the nature of consciousness. Several of his books focus on theories of the different states of consciousness a person is able to experience, as well as how to ascend to high states of being while transcending lower levels.

Towards the end of the book I’m in, Hawkins describes how it is easy to get caught up in the vast library of knowledge available on spiritual studies. He goes on to say that while valuable information does arise from deep research, it often ends up being an interference. To move towards spiritual ascension he believes it is really only necessary to know and apply a few simple tools. The efficacy of these tools is empowered through the consistency of their use.

To be useful, the tool must be simple, and brief; perhaps consisting of only a single concept. He points out that spiritual evolution is not the consequence of knowing about the truth, but the willingness to become the truth.

*It must be noted by me at this point that I wholeheartedly support the choosing by intuition, and attraction, a spiritual teacher, teachings, or a school to which one feels aligned. Whatever that source may be.

From the list below, one could pick a primary tool, plus a few others, but many are not needed. Hawkins discusses how simple tools applied consistently will result in tremendous results.

  1. Be kind to everything and everyone, including oneself, all the time, with no exception.
  2. Revere all of life in all its expressions, no matter what, even if one does not understand it.
  3. Intend to see the hidden beauty of all that exists.
  4. Forgive everything that is witnessed and experienced, no matter what.
  5. Approach all of life with humility and be willing to surrender all positionalities and mental/emotional arguments or gain.
  6. Be willing to forego all perceptions of gain, desire, or profit and thereby be willing to be of selfless service to life in all its expressions.
  7. Make one’s life a living prayer by intention, alignment, humility, and surrender. True spiritual reality is actually a way of being in the world.
  8. Accept that by spiritual declaration, commitment, and surrender, knowingness arises that provides support, information, and all that is needed for the entire journey.

Phew! Easier said than done, am I right? ^_^ Certainly these are valuable ideals to reach for, if one were so inclined. I’d love to hear of anyone’s own simple tools, or rules that they live with!

Best wishes to all,

JP

Reference:

Hawkins, D. R., M.D., Ph. D. (2006). Transcending the Levels of Consciousness. Carlsbad, CA: Hay House.

IMG_1926

Posted in Uncategorized | Leave a comment