How long should you keep clinical records?


The APA has updated and republished their “Record Keeping Guidelines” (2007 American Psychologist, 62:9, 993-1004). In this they discuss 13 separate guides (e.g., content of records, responsibility for records, confidentiality of records, retention of records, disposition of records, etc.).

How long should psychologists keep their records? This guideline suggests the full record is kept for a minimum of 7 years after the last service contact (for adult clients). Why should a psychologist destroy records? Some records might contain out-of-date assessment data that is either no longer valid or superseded by better tools. Some records might include information that was based on a very limited context and could be used against the client (e.g., 15 year old is seen for criminal activity but this information comes out at the age of 50…).

But consider the other side of destroying records. I once saw a client at a counseling center who was returning after 12 years for more counseling. This person had been in counseling for 3 years with a previous counselor who was no longer with the agency. Rules had allowed the disposal of his record. When I told him I could not review his prior record (he had asked that I do so) he was surprised and hurt that we did not keep his record. He felt that we had violated his trust in some way and that the good work that he had done was minimized. He felt the agency didn’t care about him and should have handled his history with more kindness.

So, how would you feel to go to your old therapist and find that your records no longer exist? 

5 Comments

Filed under counseling and the law, Psychology

Reading about the English language for fun?


Its end of the semester time so I’m back to reading fun things instead of grading papers. Actually, I already finished my grading–I’m just avoiding other important work like prepping for next semester and administrative tasks. On my nightstand is this book by Bill Bryson: The Mother Tongue: English and how it got that way (HarperCollins). Believe it or not, this book is interesting. Maybe I’m only interested because I have two children trying to learn spelling and pronunciation, but Bryson gives ample evidence of the insanity of the English language (e.g., how bough and though and tough are pronounced so differently; why we use teller as in bank teller; how words like brave now mean something opposite of what it used to, etc). He also helps explain how the English language developed and its connections to other languages. This may be his most interesting point: that it is clear that most European languages have the same parent as seemingly strange languages such as Sanscrit. Though he does not defend this point, it seems that linguistic study supports the idea of all languages coming from the same parent.

One interesting chapter details how English words get formed (adopted from another language as English is noted for, made up, adapted from other words, mistakenly written and carried on, etc.). He tells the reader that Shakespeare gave us 1500 plus new words–that 1:10 words he used in his writings were created new by him (or first appeared in his writings). That got me thinking of my 7 year old. He is nuts about football. Each week, he asks me who the Eagles are “versing.” Maybe a new word on the way?

I’m hoping this book will help expand my vocabulary and even help my poor understanding of grammer. But, if it doesn’t, please treat me with ruth. (look it up in the dictionary) 

2 Comments

Filed under Uncategorized

Copycat killings, why do they happen?


Notice that certain suicides and homicides lead to copycat suicides and homicides? Sadly, we seem to be witnessing this with the new shootings in Colorado right after the Omaha mall shooting. Locally, in the past year officials stopped two different individuals seeking to replicate the Columbine massacres. Why does this happen? Is it a desire to be famous (as the Omaha young man said in his note written before he went on a rampage)? Is is a fad done by those who want to fit in or connect to a certain identity (a certain APA published article sees it this way since their is an upturn in similar events and then a gradual fade)?

Obviously, this is hard to decipher well since the population of copycatters in question is actually rare, often dies in the process, and is quite twisted altogether. But, there is some research. There is a popular book, entitled: The Copycat Effect, by  Loren Coleman. Haven’t read this book but I suspect he provides lots of interesting anecdotes and lurid details, but may be thin on the actual research. I perused the APA literature this am and found most dealing with copycat suicides and guidelines for media coverage. One article spoke of the “Werther Effect”:

Debate about whether the media can influence suicidal behavior began in the late 18th century with an example from the fictional media. In Goethe’s novel The Sorrows of Young Werther, the protagonist falls in love with a woman who is beyond his reach, and consequently decides to end his own life. He dresses in boots, a blue coat, and a yellow vest, sits at his desk with an open book and shoots himself. The launch of the novel was followed by a spate of suicides across Europe, with strong evidence that at least some of those who died by suicide were influenced by the book – they were dressed in a similar fashion to Werther, adopted his method, and/or the book was found at the scene of death. For example, one young man killed himself with a pistol and was found with a copy of the book lying by his side, another young man threw himself out of a window with a copy of the book in his vest, a young woman drowned herself with a copy of the book in her pocket, and another young woman took her own life in bed with a copy of the book under her pillow. The book was banned in various European countries, despite a disclaimer included in later editions in which concluded, “Be a man, he said; do not follow my example” (Minois, 1999).

Phillips (1974)coined the term “Werther effect” to describe the situation where an observer copies behavior he or she has seen modelled in the media, in a paper describing a landmark study of the relationship between news media reports of suicide and subsequent suicidal behavior. Using a quasi-experimental design, Phillips examined the frequency of suicide in months in which a front-page suicide article appeared in the U.S. press between 1947 and 1968, and compared this with the frequency in corresponding months in which no such article appeared. Adjusting for seasonal effects and changing trends in this way, he found a significant increase in the number after 26 front-page articles, and a decrease after seven of them.

This article spoke of the existence of media guidelines for coverage of suicides (and I would add homicides). Sadly, they mention that most American journalists seemed unaware of these guidelines (avoiding rich detail, sensationalism, addressing the hurt to families more than the shooter’s background, etc.)

In 2002 Julie Peterson-Manz wrote a dissertation on the link between increases in homicides after the media sensationalized celebrity involved homicides with rich descriptive, words, multiple stories, identification with the killer. When two or more of the priming effects were found, homicides increased in LA over the subsequent 2 weeks. BUT, when the media spent more time on the consequences to the perpetrator, same weapon homicides decreased over the next 2 weeks.

So, why do copycat murders and suicides take place? Media. And who drives media? We do. Are we to blame? Partly. We do lust to know the details. I admit to getting on-line to learn what I could about the Colorado shootings. I wanted to know who, when, where, why? The same desire to know, leads some to use this information to repeat what they see. Are we responsible for that? No. But, do we need to know as much as we desire? That is the question of the day.

I suspect this problem is much more common than we think. Who’s to say that copycat murders aren’t happening every day in Philadelphia?

3 Comments

Filed under Cultural Anthropology, Psychology

Check out these thoughts on christian hero worship


Check out this good read on our propensity to put certain Christian leaders on a pedestal. Cavman has some insights into this problem and a reminder to read widely.

http://cavman.wordpress.com/2007/12/07/considering-christian-hero-worship/

Leave a comment

Filed under Uncategorized

The science of happiness and why we are not


My latest Monitor on Psychologyfrom the APA (December, 07) has a couple of short articles on happiness. One mentions that 1998 study that found Midwesterners predicting Californians would be happier because of their climate. Apparently not true. The author suggests that we’re not that good at predicting what makes us happy and are likely to focus on one positive or negative and neglect other factors that might be important. This sound quite true to me. We tend to point to particular anecdotes from our day/life and use those to confirm our set opinion about whether we are happy or not.

One other little tidbit on p. 38. “White Americans expect to be happy, so day-t0-day positive events have less effect on their overall mood than such events have on Asians and Asian Americans… Negative events, however, are a different story.”

It appears that it takes two positive events to offset a negative experience for White Americans. For Asian Americans, it takes only one.

Interesting. The researching author is quoted as saying, “the happier you get, the more powerful negative events become.” I suspect the truth is more like this. The happier you think you should and can be, the more powerful negative events become. I’m not sure we are more happy. But, I am sure we think we should be.   

Leave a comment

Filed under counseling science, Cultural Anthropology, Psychology

How do you evaluate the “next best thing” in Christian Counseling?


Last Monday we discussed this topic in my social and cultural foundations of counseling. There are always new ideas and books trumpeting something exciting that surpasses other counseling techniques with successes never seen before. Just read this book and your life will change forever!

Do you hear my voice dripping with suspicion? You should. While there are advances in counseling, popular books are often just that because they package a good idea or two into something that people want to buy (which means they also package it with fluff). What do we want to buy? Freedom from suffering; the end of our sorrows and struggles; we want complete removal of mental pain. This isn’t a bad desire, but it does set us up to buy the “next best thing” without proper critical evaluation.

And yet, we need to be open to the possibility that there is something new on the horizon. And so, I propose we do the following:

  1. Read with an open mind. Ask these questions: What does this author observe about their world, about people, about change? What are the problems they see? What are the solutions they envision? Can we see what they see? Can we consider the importance of what their observations?
  2. What techniques and interventions do they use to solve the problems they see? We may disagree with authors at numerous points but we can still evaluate the techniques they use. Do they work? How do we know?
  3. What assumptions, worldviews, presuppositions, etc. bleed through on their pages? I used to always go here first. The problem was it made me unwilling to consider their observations if they were wrong in their assumptions. But everyone sees—even if poorly. And observations can be very helpful—even if fixated on one small aspect of life.
  4. How might their observations and assumptions challenge mine? Where are my assumptions and worldviews uncritically formed; based on faulty logic or distorted beliefs?
  5. What techniques or interventions might find a home in my repertoire and what impact would they have on my work?
  6. What promises do they offer that must be critiqued? What misrepresentations must be exposed? What admissions must be made about our own models as a result of their work?

Now, these are good questions to use to evaluate the “next best thing” that actually has substance and as several commenters observed, creation therapy probably doesn’t merit this level of work until it moves into the realm of transparency and shows that it is available for observation and critique. With research on 5,000 individuals, where is the evidence? The real challenge is evaluating those models that run too far with a few facts and ideas and sell it as a type of cure-all. Much of the “change your brain, change your behavior” popular literature out there does just this. Some significant piece of data is then used to promote an idea that one can change everything.

2 Comments

Filed under christian counseling, christian psychology, counseling science

Ever hear of _____Therapy (the latest christian model)?


Someone recently mentioned “Creation Therapy” as the latest Christian counseling treatment. Ever heard of it? Is it any good?

You be the judge. Google it (with quotes) and tell me what your first impressions are of the several sites that mention it (and therefore impressions of the therapy). How would you go about evaluating the tools?

Tomorrow, I’ll make some comments on good ways to evaluate up and coming models of christian counseling.

4 Comments

Filed under christian counseling, counseling

Parent-teacher conferences and being graded as a parent


Our annual parent-teacher conferences took place this morning. We met with with our children’s teacher to get their first quarter grades and discussed pertinent matters. Every time we do this I find myself holding my breath, wondering what I’ll hear. There’s a part of me that believes I’m getting graded as well or I’ve just been sent to the Principal’s office.

What external things do you use to assess your “grade; your identity?” Your kids behavior in public? Your job title or pay? Your gpa? If we’re honest, we use things like this to determine our success or failure in life. Many of  these things we have little control over and yet we allow them to “determine” what we think and feel about ourselves.

By the way, I feel good about myself because both kids made honor-roll.

1 Comment

Filed under Identity

Ebola outbreak in Uganda


Our church and World Harvest Mission (started by our founding pastor many years ago) have connections to mission work in Bundibugyo, Uganda. The medical team there is in the middle of an Ebola outbreak and some of their staff are sick with the disease. The team has sent the non-medical staff and children away for safekeeping but the missionary docs may have been exposed to the illness or are at least at risk of it.

Consider praying for the team each day for the next 3 weeks as they labor to control the disease and treat those suffering. It is very deadly. Here’s a link to a blog by one of the doctors. You can read and pray specifically for their needs. http://www.paradoxuganda.blogspot.com/

Leave a comment

Filed under Uncategorized

Greed and illicit sex: Would you treat them as equals?


Our visiting professor, Richard Smith, (and my good friend) had us faculty meditate on Paul’s teaching regarding greed. He had us read Col 3:5-7 and Eph 5:3-5. In both passages Paul puts both greed and sex on the same footing: they are both forms of idolatry.

He asked us to consider how greed might infiltrate our lives (yes, even impoverished seminary profs). Do we, like our culture, consider greed a petty vice or perverse? Would we be inclined to use church discipline when greed appears (1 Cor. 5:9-11 suggests so)?

What is the line between justice and demand; between security and self protectionism?  I raised a concept that I heard from a development officer of a local nonprofit. He talked about nonprofit greed. We fantasize and imagine security where we no longer have to ask for money or worry about next year’s budget. Ever had that fantasy? I do. 

By the way, I suspect this devotional work we have been doing of late is rather rare for faculty. We faculty are already arrived and we make decisions on the proper way to teach and the proper way to govern. But how many faculty meetings give ample time to applying biblical truth to their own lives. Its not normal and we tend to slide back into intellectual discussions…

Okay, now that I’ve felt pride for our faculty, I better go and repent of this vice 🙂

1 Comment

Filed under Biblical Reflection