PhD/PsyD Just a thread to post the weirdest/whackiest/dumbest mental health-related stuff you come across in the (social) media...

[PsyDr]

Not to revive that particular argument, but we lost our minds in the sense that we told you the answer is that as an actual matter of fact and practice we generally do not specify a diagnosis for this purpose. The medication is being used in a non-specific way and the context you posited was specifically an in-patient setting. You found this answer inadequate but unfortunately reality is often disappointing.

if you notice, I often use SDN as a lab to test out ideas. Perhaps that discussion was motivated by something other than pure curiosity. I didn’t find the result disappointing at all. It’s like in trial, if you can’t argue the point, you argue emotion, if you can’t argue emotion, you attack the man.

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[PsychSupreme]

Folks on r/therapists are in love with somatic therapy…Bessel van Der Kolk has really done us all a huge disservice

 

[WisNeuro]

Folks on r/therapists are in love with somatic therapy…Bessel van Der Kolk has really done us all a huge disservice

Don't forget IFS on that sub. The more improbable and absurd the "treatment" is, the more they love it.

 

[PsychSupreme]

Don't forget IFS on that sub. The more improbable and absurd the "treatment" is, the more they love it.

And don’t even dare to ask for evidence of theoretical validation or even basic efficacy trials! And definitely don’t bring up the Castlewood lawsuits!

 

[WisNeuro]

And don’t even dare to ask for evidence of theoretical validation or even basic efficacy trials! And definitely don’t bring up the Castlewood lawsuits!

You're just a shill for Big CBT!

 

[cara susanna]

Here's a new one for the Bingo card: there are so many studies on CBT's effectiveness because they get the most research funding

 

[WisNeuro]

Here's a new one for the Bingo card: there are so many studies on CBT's effectiveness because they get the most research funding

It's all a Deep State CBT thing. Aaron Beck and Albert Ellis are still alive, having transferred their consciousness to android bodies, and they are directing funding towards CBT only and manipulating data for their own nefarious ends!

 

[R. Matey]

I think it might be time to bring back Mesmerism--there's clearly a market for it.

 

[AcronymAllergy]

I also would like to call for a resurgence of trephination. With some leeches thrown in for good measure.

I also will not at all be surprised when I see discussion about the four humors pop back up. Probably in relation to brainspotting.

 

[WisNeuro]

I also would like to call for a resurgence of trephination. With some leeches thrown in for good measure.

I also will not at all be surprised when I see discussion about the four humors pop back up. Probably in relation to brainspotting.

Brianspotting is especially efficacious for those with an overabundance of black bile.

 

[RxPsych]

Brianspotting is especially efficacious for those with an overabundance of black bile.

You must be referring to the black bile that results from intergenerational trauma? I thought bloodletting was the go to treatment for that.

 

[R. Matey]

You must be referring to the black bile that results from intergenerational trauma? I thought bloodletting was the go to treatment for that.

idk...you really haven't lived until you felt the relief from intergenerational trauma that comes from the cool touch of a magnetic rod.

 

[WisNeuro]

You must be referring to the black bile that results from intergenerational trauma? I thought bloodletting was the go to treatment for that.

No, intergenerational trauma is obviously perpetuated by demons in the brain that are passed on at birth. One needs to first do some "parts" work to isolate the demon from the benevolent spiritual forces in the pituitary, then confuse the demon with bilateral stimulation, and then finally threphination to allow the demon to exit the confines of the skull/psyche.

 

[PsychSupreme]

It's all a Deep State CBT thing. Aaron Beck and Albert Ellis are still alive, having transferred their consciousness to android bodies, and they are directing funding towards CBT only and manipulating data for their own nefarious ends!

They’re also paying the insurance companies to dictate coverage of certain modalities and thereby dictate that researchers only research things that insurance will cover! Don’t forget that very important step in the conspiracy.

 

[The Cinnabon]

It's all a Deep State CBT thing. Aaron Beck and Albert Ellis are still alive, having transferred their consciousness to android bodies, and they are directing funding towards CBT only and manipulating data for their own nefarious ends!

What H-Index do we need to get cool android bodies ... asking for a friend?

 

[borne_before]

Dudes, can I just share this with y'all - but I've dabbled in some non-cbt stuff. But I do kid therapy, and kid therapy is hard. But, one of the things I love about CBT is when you teach a kiddo to recognize an ANT, guide them through the cognitive distortions/examine the evidence/etc, and you see their affect/nonverbals change as a result. You feel like you're teaching a kiddo a skill that will serve them through times of hardship in the future. Super cool to see.

 

[WisNeuro]

What H-Index do we need to get cool android bodies ... asking for a friend?

H-index in the 6 figures, and a Thetan level of 8

 

[PsychSupreme]

There is now a thread on r/therapists in which folks are bashing measurement-based care…

 

[PsychSupreme]

H-index in the 6 figures, and a Thetan level of 8

Pshh, amateur

 

[PsychSupreme]

Today I learned (/s) that people crying during massages is proof that emotions are stored in the body.

 

[ccpsych16]

Has anyone ever interacted with “intake coordinators” or is one? I’ve seen USAJobs postings for psychologist positions and this title keeps popping up. It’s unclear whether they’re brief assessment and triage/case management or if they actually carry a caseload as well. The postings I’ve seen have been exclusively remote. I’m looking to make a move by the end of the year for family reasons (bittersweet, I really enjoy my current job) and am curious about this. TIA.

 

[Shiori]

Has anyone ever interacted with “intake coordinators” or is one? I’ve seen USAJobs postings for psychologist positions and this title keeps popping up. It’s unclear whether they’re brief assessment and triage/case management or if they actually carry a caseload as well. The postings I’ve seen have been exclusively remote. I’m looking to make a move by the end of the year for family reasons (bittersweet, I really enjoy my current job) and am curious about this. TIA.

It seems to vary site to site. In one of our big meetings, we brainstormed how we want this role to look based on how other places have done it. They might try to standardize this down the line, but it seems like a free-for-all at the moment.

 

[ccpsych16]

It seems to vary site to site. In one of our big meetings, we brainstormed how we want this role to look based on how other places have done it. They might try to standardize this down the line, but it seems like a free-for-all at the moment.

Thanks for the insight. That sounds like it could be a good or bad thing (for me personally). I understand why they don’t do this, but it would be nice to have clinical staff contact info to field these kinds of questions to.

 

[texanpsychdoc]

I actively avoid confronting people who have different beliefs than mine, especially when they are asinine. I don't find much utility in trying to insist someone else see a different viewpoint that runs counter to their for whatever the reason. Besides, I don't get paid to do that, so I am not wasting my time. I am also of the mindset...I don't like to repeat myself and argue. If I do state my position on a controversial topic, I keep it at that, I don't do back and forth. People are free to believe whatever they want. At the end of the day, I am just trying to make money to support my family and my hobbies and interests, so anything that makes that more stressful I just opt to not engage in it.

 

[cara susanna]

I don't really do it with the goal of changing that person's mind, I do it with the goal of combating misinformation for the benefit of people who might be reading the discussion.

 

[PsychSupreme]

Newest update: therapist on r/therapists is unsure if just providing a safe space without providing directive feedback is sufficient for doing therapy.

 

[PsychSupreme]

Sorry to flog a dying thread, but another good one from this week is a therapist claiming that IFS can be seen as evidence based because all therapy works, per the Dodo Bird verdict. Which--not even considering the criticisms of the Dodo--is just not what the Dodo posits.

 

[WisNeuro]

Sorry to flog a dying thread, but another good one from this week is a therapist claiming that IFS can be seen as evidence based because all therapy works, per the Dodo Bird verdict. Which--not even considering the criticisms of the Dodo--is just not what the Dodo posits.

These are not serious people.

 

[PsychSupreme]

These are not serious people.

I agree. But they are seriously licensed.

 

[Sanman]

I agree. But they are seriously licensed.

They are usually midlevels. I would be more concerned if these were psychologists. That said, I'd be worried if I had health insurance that reimbursed MH services poorly. Then again, that can be said for all services. My personal physician is opting out of insurance and moving to a direct care model as well. Pretty much only NPs left at the insurance based outpatient practices.

 

[WisNeuro]

They are usually midlevels. I would be more concerned if these were psychologists. That said, I'd be worried if I had health insurance that reimbursed MH services poorly. Then again, that can be said for all services. My personal physician is opting out of insurance and moving to a direct care model as well. Pretty much only NPs left at the insurance based outpatient practices.

Luckily, we have a lot of physician friends, so we can get informal consults and such. I don't really go to urgent care anymore, all midlevels these days.

 

[PsychSupreme]

They are usually midlevels. I would be more concerned if these were psychologists. That said, I'd be worried if I had health insurance that reimbursed MH services poorly. Then again, that can be said for all services. My personal physician is opting out of insurance and moving to a direct care model as well. Pretty much only NPs left at the insurance based outpatient practices.

Maybe I am just young and naive, but the fact that folks don't generally know the difference between therapists and psychologists, and that mid-levels are the majority of licensed mental health workers, just makes me cynical about the potential of us successfully advocating for science-based practice.

 

[Sanman]

Maybe I am just young and naive, but they fact that folks don't generally know the difference in therapists and psychologists and that mid-levels are the majority of licensed mental health workers just makes me cynical about the potential of us successfully advocating for science-based practice.

Who do you plan to advocate to about science based practice? Insurance based work pays peanuts and they set their own guidelines for care and medical necessity. Cash based practice is buyer beware. Psychology, as a profession, has failed to advocate for much more modest goals to CMS and other federal agencies.

 

[WisNeuro]

Maybe I am just young and naive, but they fact that folks don't generally know the difference in therapists and psychologists and that mid-levels are the majority of licensed mental health workers just makes me cynical about the potential of us successfully advocating for science-based practice.

Very little appetite for advocacy of practice issues and guild protection by newer and midlevel psychologists these days. I've honestly kind of given up here. I'm just going to continue on making money in the legal realm while the gettings good. I don't have much hope that in a decade, psychologists will be on par with midlevels in clinical pay structures, with only ourselves to blame. Have fun kids.

 

[Sanman]

Very little appetite for advocacy of practice issues and guild protection by newer and midlevel psychologists these days. I've honestly kind of given up here. I'm just going to continue on making money in the legal realm while the gettings good. I don't have much hope that in a decade, psychologists will be on par with midlevels in clinical pay structures, with only ourselves to blame. Have fun kids.

Few who can command more have any interest in taking anything but cash. This is happening with concierge medical practices as well.

 

[WisNeuro]

Few who can command more have any interest in taking anything but cash. This is happening with concierge medical practices as well.

There will likely be an exacerbation of the two tiered system, those who can afford to pay out of pocket for doctoral care, and those who have to see midlevels and diploma millers.

 

[PsychSupreme]

Who do you plan to advocate to about science based practice? Insurance based work pays peanuts and they set their own guidelines for care and medical necessity. Cash based practice is buyer beware. Psychology, as a profession, has failed to advocate for much more modest goals to CMS and other federal agencies.

I’m not sure I would say I’m looking to advocate to change the minds of those already entrenched in bad practice…I’m more interested in ground-up reforms through systematic overhauls of how psychology is taught at the undergraduate level. It’s way beyond any goal I will ever achieve, sure, but a man can dream! (And I do believe that gradual change is feasible.) I know it’s a somewhat controversial topic here, but I have fully drunk the PCSAS Flavor Aid.

 

[WisNeuro]

I’m not sure I would say I’m looking to advocate to change the minds of those already entrenched in bad practice…I’m more interested in ground-up reforms through systematic overhauls of how psychology is taught at the undergraduate level. It’s way beyond any goal I will ever achieve, sure, but a man can dream!

The field of psychology is currently in the Precontemplative stage of change as it relates to doing anything of value to advance science and guild interests. As we say to our supervisees in therapy, don't work harder then the patient.

 

[PsychSupreme]

The field of psychology is currently in the Precontemplative stage of change as it relates to doing anything of value to advance science and guild interests. As we say to our supervisees in therapy, don't work harder then the patient.

I refuse to believe Lilienfeld labored in vain! Lol

 

[Sanman]

I’m not sure I would say I’m looking to advocate to change the minds of those already entrenched in bad practice…I’m more interested in ground-up reforms through systematic overhauls of how psychology is taught at the undergraduate level. It’s way beyond any goal I will ever achieve, sure, but a man can dream! (And I do believe that gradual change is feasible.) I know it’s a somewhat controversial topic here, but I have fully drunk the PCSAS Flavor Aid.

Drink whatever you like. My problem with PCSAS is that they go about things in the same tired old academic way of elitism. As you divide into smaller and smaller groups, you subject yourself to irrelevancy. While they are producing a few dozen people, the other folks are producing thousands. Eventually, no one will care what you think.

 

[PsychSupreme]

Drink whatever you like. My problem with PCSAS is that they go about things in the same tired old academic way of elitism. As you divide into smaller and smaller groups, you subject yourself to irrelevancy. While they are producing a few dozen people, the other folks are producing thousands. Eventually, no one will care what you think.

I don't agree with this take, but to each their own.

 

[Sanman]

I don't agree with this take, but to each their own.

No one said you had to. That's the beauty of open-minded discussion and debate.

 

[WisNeuro]

Drink whatever you like. My problem with PCSAS is that they go about things in the same tired old academic way of elitism. As you divide into smaller and smaller groups, you subject yourself to irrelevancy. While they are producing a few dozen people, the other folks are producing thousands. Eventually, no one will care what you think.

Just a point of reference, there are currently 47 PCSAS programs, and the programs on that list are mostly very good programs. I don't think they are in danger of sliding into irrelevancy anytime soon. They're more than 10% of the overall programs and growing.

 

[Sanman]

Just a point of reference, there are currently 47 PCSAS programs, and the programs on that list are mostly very good programs. I don't think they are in danger of sliding into irrelevancy anytime soon. They're more than 10% of the overall programs and growing.

Compare that to about 400 APA accredited programs give or take. From a advocacy standpoint, what do you think that PCSAS is going to accomplish that APA cannot with approximately 10-12% of the membership numbers and less money? Stricter standards for psychotherapy? Increased reimbursement for EBPs vs supportive therapy? Probably not as their focus is clinical science programs. So their goal is to train more professors and scientists in an era where colleges are going broke and there is less money for funded PhD programs and fewer academic positions? Walk me through how that changes anything.

 

[WisNeuro]

Compare that to about 400 APA accredited programs give or take. From a advocacy standpoint, what do you think that PCSAS is going to accomplish that APA cannot with approximately 10-12% of the membership numbers and less money? Stricter standards for psychotherapy? Increased reimbursement for EBPs vs supportive therapy? Probably not as their focus is clinical science programs. So their goal is to train more professors and scientists in an era where colleges are going broke and there is less money for funded PhD programs and fewer academic positions? Walk me through how that changes anything.

Yes, comparatively small, but growing at a good clip, but a good deal more than graduating a "few dozen" people. I'm not optimistic that any psychology organization will have much sway in the next decade, but, with the path that APA is taking, I definitely align more with PCSAS's take on the field and integrity. Also, they're not training sole researchers/professors. Their own metrics show that the clear majority of their graduates are providing clinical care as part of their jobs, and some of those programs are definitely well within the "balanced" part of the spectrum. In the long run, things will probably stay more the same than any real change, but I'll definitely support the model with actual standards in comparison to the one that sold themselves out to the diploma mills.

 

[Sanman]

Yes, comparatively small, but growing at a good clip, but a good deal more than graduating a "few dozen" people. I'm not optimistic that any psychology organization will have much sway in the next decade, but, with the path that APA is taking, I definitely align more with PCSAS's take on the field and integrity. Also, they're not training sole researchers/professors. Their own metrics show that the clear majority of their graduates are providing clinical care as part of their jobs, and some of those programs are definitely well within the "balanced" part of the spectrum. In the long run, things will probably stay more the same than any real change, but I'll definitely support the model with actual standards in comparison to the one that sold themselves out to the diploma mills.

I don't have any problem with the goals of PCSAS. I just don't believe they are going to change anything. Maybe a few dozen was an understatement, but not by much. 47 programs x a median of 6 grads = 282 PCSAS grads. I imagine the Chicago School graduates more PsyD grads per year between their campuses. Let alone the mid levels. And their profits are much larger. When it comes to advocacy, you know the numbers matter and so does the money. We missed the boat in not embracing a master's credential that is supervised by doctoral level providers. Most of the masters programs do their own thing and have the numbers to be the loudest voices.

 

[WisNeuro]

I don't have any problem with the goals of PCSAS. I just don't believe they are going to change anything. Maybe a few dozen was an understatement, but not by much. 47 programs x a median of 6 grads = 282 PCSAS grads. I imagine the Chicago School graduates more PsyD grads per year between their campuses. Let alone the mid levels. And their profits are much larger. When it comes to advocacy, you know the numbers matter and so does the money. We missed the boat in not embracing a master's credential that is supervised by doctoral level providers. Most of the masters programs do their own thing and have the numbers to be the loudest voices.

I don't believe the chances of meaningful change in the right direction is all that high, but I think PCSAS has a higher small chance than APAs nonexistent chance of positive change. If I'm buying a lottery ticket, I'll take the one in a million chance ticket over teh one in a billion chance ticket.

 

[Ollie123]

The main thing I like about PCSAS is that I think they actually have a vision for psychology careers that goes beyond "You can be a professor or you can do 1:1 therapy 40 hours/wk." Historically....those were our choices. If you stepped outside those, you did it of your own volition and largely despite your graduate training and not because of it. That said, they are definitely playing the long game - it is being done to fundamentally reshape what psychology as a field looks like 20-30 years down the road, not what happens to medicare reimbursement next year. Long-term, I do think they are going to have a substantial impact. That doesn't mean medicare reimbursement for psychotherapy is going to triple. I do think it will mean psychologists in a wider variety of better-paying roles across different settings (insurance, hospital administration, hybrid clinical/leadership roles, government, certain technology sub-sectors, etc.). Right now, PCSAS programs have still had to carry APA accreditation concurrently to keep folks eligible for licensure, which limits their flexibility on the curriculum. That is starting to change and I think once that happens it is going to open the floodgates for far more innovation on the educational front.

I've said it before here, but I really don't view professional school PsyD grads as being much different from mid-levels and in many cases actually seem to get worse training than the quality LCSW/LPC/etc programs. It will obviously take time to shake out, but I do think we're on a trajectory to eventually have a two-tier system where PCSAS grads have options for higher pay and APA grads are closer to mid-level roles. Obviously this could change, but that is where I see it going right now. Definitely not ideal, but I fear without that we'd just be seeing the entire field pushed towards mid-level roles.

I'm sympathetic to concerns about further fracturing the field. At the same time, it was largely championed by people shouting from the rooftops that APA was doing a terrible job for quite literally decades while the powers that be played musical chairs. No one did **** and in fact actively tried to stop others from doing ****. Eventually, you have to cut your losses and do what you think is right.

 

[Sanman]

I don't believe the chances of meaningful change in the right direction is all that high, but I think PCSAS has a higher small chance than APAs nonexistent chance of positive change. If I'm buying a lottery ticket, I'll take the one in a million chance ticket over teh one in a billion chance ticket.

We don't really disagree here that much other than maybe arguing the exact odds.

 

[WisNeuro]

The main thing I like about PCSAS is that I think they actually have a vision for psychology careers that goes beyond "You can be a professor or you can do 1:1 therapy 40 hours/wk." Historically....those were our choices. If you stepped outside those, you did it of your own volition and largely despite your graduate training and not because of it. That said, they are definitely playing the long game - it is being done to fundamentally reshape what psychology as a field looks like 20-30 years down the road, not what happens to medicare reimbursement next year. Long-term, I do think they are going to have a substantial impact. That doesn't mean medicare reimbursement for psychotherapy is going to triple. I do think it will mean psychologists in a wider variety of better-paying roles across different settings (insurance, hospital administration, hybrid clinical/leadership roles, government, certain technology sub-sectors, etc.). Right now, PCSAS programs have still had to carry APA accreditation concurrently to keep folks eligible for licensure, which limits their flexibility on the curriculum. That is starting to change and I think once that happens it is going to open the floodgates for far more innovation on the educational front.

I've said it before here, but I really don't view professional school PsyD grads as being much different from mid-levels and in many cases actually seem to get worse training than the quality LCSW/LPC/etc programs. It will obviously take time to shake out, but I do think we're on a trajectory to eventually have a two-tier system where PCSAS grads have options for higher pay and APA grads are closer to mid-level roles. Obviously this could change, but that is where I see it going right now. Definitely not ideal, but I fear without that we'd just be seeing the entire field pushed towards mid-level roles.

I'm sympathetic to concerns about further fracturing the field. At the same time, it was largely championed by people shouting from the rooftops that APA was doing a terrible job for quite literally decades while the powers that be played musical chairs. No one did **** and in fact actively tried to stop others from doing ****. Eventually, you have to cut your losses and do what you think is right.

I believe many of the bigger (population-wise) states already have statutes recognizing it, and I know my state is currently changing it's practice rules around to recognize it as well. I'd say within the decade nearly all states will have adopted these statutes of recognition for licensure.