Review of How to Fail as a Therapist: 50+ Ways to Lose or Damage Your Patients

 I would like to share with you a little book that was recommended to me by Janice Maddox of Reno Counseling through a comment on my blog: How to Fail as a Therapist: 50+ Ways to Lose or Damage Your Patients.  This book inspired Janice to begin getting feedback on the quality of her services from her clients. This book has many helpful suggestions, not just on soliciting client feedback, but also on talking to patients about medication, conducting research, and avoiding burnout.

As a the title suggests, How to Fail as a Therapist is a bit snarky and satirical. Written by Bernard Schwartz and John Flowers, both of whom are PH.D psychologists and clinical supervisors, this book draws heavily on fictional and real examples of how both new and experienced therapists interact with their clients. Such examples are short and illustrate the points in each chapter rather well.

How to Fail as a Therapist uses chapter titles similar to the book title, which in my opinion, makes the book rather fun. The first chapter, titled “How to fail before you start therapy – The intake process” sets the tone for the book. The authors go on to address the problem the chapter title suggests, then offers ways that therapists can avoid making the same error. Each chapter afterwards follows in a similar manner.

I believe that this book is invaluable to new counselors because it addresses common problems that arise while learning how to meet the needs of our clients. The section on “How to avoid collaboration with the client” was helpful to me because it reminded me that I do not have to have all the answers. Sometimes it is our clients that come up with a great solution, and we need to celebrate this more often. Ultimately, the client is likely to experience a better outcome when he or she is a part of generating a solution. Each chapter provides so many great suggestions that you will likely walk away with a few great insights and ideas each time you flip through the book.

I think counselor educators should use How to Fail as a Therapist as part of their programs. It enriches the discussion by showing clearly the mistakes that we all can unintentionally make while learning our craft. Plus, it adds an element of reality. Sometimes in our graduate programs we can forget that therapy is serious, that our clients’ pain is real and they are looking for ways to ease this pain. This book reminds us that we need to take care, involve our clients, avoid our own burnout, keep abreast of current research, and help turn around bad attitudes, among many similar directives.

How to Fail as a Therapist is an entertaining read and a helpful one too. This little volume is easy to read, understand, and use because it shows the common mistakes but also offers solutions to avoid these pitfalls. I hope that if you read it you find it as helpful as I have in my practice.

–Sean Stanek, MA, LMHP, LPC

Are you in control of your anger? Or does it control you? We all feel angry at times, and it can actually serve a useful purpose in some situations, but when this powerful emotion gets the better of us, it’s no easy task to rein it back in.

That doesn’t mean that there’s no hope for managing one’s anger, however. “I always figured that my Dad had a bad temper and I inherited it from him… that there wasn’t really anything I could do about it,” comments Cynthia, a 46-year-old businesswoman. “I knew I could try to control whether or not I acted on it – you know, laid on the horn in traffic or something – but if I was going to get mad, it was just going to happen and that was that! Now that I realize I can actually avoid even getting angry, I am so much happier! I don’t fight my emotions all of the time.”

No matter what sparks our anger: careless drivers, billing errors, rude co-workers, selfish siblings – none of us have the power to eliminate all of these annoyances from our lives. We can’t prevent the world from creating the irritants which make us angry, so that really leaves only one option: changing the way we think about those unpleasant events. “The way you think about events has a powerful influence over your feelings and actions,” state clinical psychologists and anger experts Chip Tafrate and Howard Kassinove. “Your thinking contributes to your anger and to some of the self-defeating behaviors that go along with it.”

Cynthia knows her perceptions were causing her anger problem, “My brother was driving us to a restaurant when some guy cut him off and then gave him the finger. Tom just waved at the guy like it was no big deal and didn’t even let it bother him. I was downright amazed!” she laughs, “I knew then that having my dad’s temper wasn’t the problem, my attitude was.” Tafrate and Kassinove agree: “Becoming more aware of how you typically think when you become angry and changing these long-standing thoughts are key in reducing anger. The good news is with some effort and practice you can change the way you think about unpleasant events and thereby reduce your anger and increase your joy and happiness.”

Drs. Tafrate and Kassinove, authors of Anger Management for Everyone: Seven Proven Ways to Control Anger and Live a Happier Life (November 2009, Impact Publishers, Atascadero, CA), have developed a program which suggests key steps to controlling one’s anger, among them:

Analyze past anger episodes you’ve experienced in order to recognize the events which trigger your anger.

Identify your thoughts to find if you are distorting or exaggerating the situation unnecessarily.

Learn relaxation techniques and how to apply them when needed.

Discover assertive, productive ways to express your anger.

Tafrate and Kassinove offer specific exercises, evaluation charts, and examples in their book to help participants implement the program, so “… you learn to reduce your anger, you’ll be able to make better decisions in your life, manage your relationships better, and behave in ways that are likely to bring about the results you want the most. Misfortune, unfairness, and disappointment are part of everyone’s life; we’ll show you how to think about such events – and respond to them – constructively.”

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Raymond Chip Tafrate, Ph.D., is a clinical psychologist, professor, and chairperson of the Criminology and Criminal Justice Department at Central Connecticut State University. Dr. Tafrate serves as a consultant to state criminal justice agencies and trains practitioners in client engagement skills and the application of cognitive-behavioral interventions. His research on the nature and treatment of anger has been published in scientific journals and books, and presented at international conferences.

Howard Kassinove, Ph.D., ABPP, a board certified clinical psychologist, is past chairperson of the Psychology Department at Hofstra University and past director of their Ph.D. Program in Clinical & School Psychology. He is director of the Institute for the Study and Treatment of Anger and Aggression, and a Fellow of the American Psychological Association, the American Psychological Society, the Albert Ellis Institute, and the Behavior Therapy and Research Society.

Anger Management for Everyone is published as a trade paperback and available at online and local bookstores nationwide or directly from Impact Publishers, P.O. Box 6016, Atascadero, CA 93423-6016, www.impactpublishers.com, or phone 1-800-246-7228.

Most parents struggle with the ongoing issue of how much financial support to give to their children. The problem becomes that much more pressing when their son or daughter seeks help during his or her separation and/or divorce. Especially in these tough economic times when seniors find their retirement and pension funds less secure, there will be issues affecting family relationships.

Jack held off offering his daughter Bonnie money when she and her husband separated. In the beginning, his soon to be ex son-in-law was meeting his responsibilities. But then Phil lost his job and Jack came through with a monthly check to pay for her household expenses.

Bonnie appreciated her dad’s help. Once her divorce was finalized (and Phil got a job), Jack assumed he would be off the hook. Instead he found, a year later, he was still digging into his wallet.

Parents who want to help their children during this difficult time ask the following questions:

When should I withdraw financial support?

While there is no easy answer, the rule of thumb is not to create a dependency situation. Circumstances vary in each case, but keep in mind that when you offer to help your divorcing child financially, you are setting a precedent for the future — not only for that child, but also for any other child who might one day come to you with a similar request.

Should I loan the money or make it a gift?

Even if it’s a loan — “Only give what you can afford not to get back.” If you expect your child to pay you back, establish a realistic pay-back plan. You can avoid creating a dependency if you pay for a particular expense (rent for a year, for example), instead of giving a blanket loan. One attorney suggested considering a promissory note to accompany a loan as this then becomes a marital debt and is added to the financial affidavit. The loan has a better chance of being repaid once the assets are divided.

Should I specify how the money is spent?

For better or worse, once the money leaves your hands, consider it a fait accompli. If your son or daughter has been financially irresponsible in the past — thrown away money, run up high credit card debt, taken money for granted — you may have to set limits right from the start. Remember, you are dealing with an adult. Just hope that the money you so generously shelled out will be used wisely.

What if my child comes back asking for another loan?

That’s easy. Gently remind him or her that you have expenses, and that there are other means for obtaining the money.

Am I being selfish if I turn down a request?

It’s not easy to draw the line, but it’s also wrong to lose sight of your needs, your spouse’s, or other family members you are taking care of. More and more baby boomers are members of the club sandwich generation, responsible for kids living at home and elderly parents who are living to a ripe old age.

You’re not being selfish if a gift to your child is going to compromise your lifestyle or cause you to put your retirement plans on hold. Even if your plans seem “frivolous” — that safari trip you’ve waited your whole life to go on — you have a right to use your money as you see fit.

Am I being fair to the other family members if I support my neediest child?

If maintaining your divorced child’s standard of living means creating tension and resentment, you better think again. Be aware that a loan to your divorced child can build guilt and resentment that can last a lifetime.

Case in point: Cathy is sixteen and a straight A student. Instead of going to that private college she set her sights on, she is attending her local community college. Why? Her parents used her college fund to pay off her divorced sister’s mortgage.

The best policy is to be open and honest with other family members about the kind of financial help you are giving your divorced child. Money lending (or gifting) can be especially dicey when one of the parents is remarried. Partners may not always agree how the money should be spent or how “desperate” the divorced child’s situation is.

The best kind of support may not cost a dime.

Know that there are many ways you can communicate your love and support without having to open your purse strings: open your home, fix dinner, offer to babysit, carpool, attend your grandchildren’s sports events, research lawyers and divorce tax consultants, take your child and grandchildren on vacation, etc. By relieving the day-to-day burden you will be showing your generosity.

As a parent your role is not to provide long-term financial support unless there is no other recourse. As I said earlier, circumstances vary. But generally speaking, your goal is to point your divorced or separated adult child toward financial independence. Doing too much and for too long is as bad as doing too little.

There are many more tips how to help your son or daughter pre- or post-divorce in my book “Your Child’s Divorce: What to Expect – What You Can Do” (Impact Publishers, 2006.)

Original post can be found at http://www.huffingtonpost.com/marsha-temlock/the-parents-dilemma-open-_b_984048.html

A difference between an addict and a recovering addict is that one hides his behavior, while the other can’t stop talking about it. Self-revelation is an important part of recovery, but it can lead to awkward moments when you meet a person who identifies as a sex addict.

For instance, within a half-hour of my first meeting Neil Melinkovich, a 59-year-old life coach, sometime writer and former model who has been in Sex Addicts Anonymous for more than 20 years, he told me about the time in 1987 that he made a quick detour from picking up his girlfriend at the Los Angeles airport so he could purchase a service from a prostitute. Afterward, he noticed what he thought was red lipstick on himself. It turned out to be blood from the woman’s mouth. He washed in a gas-station bathroom, met his girlfriend at the airport and then, in the grip of his insatiability, had unprotected sex with her as soon as they got home — in the same bed he said he had used to entertain three other women in the days before.(See how addiction affects the brain.)

Is this a man with colossally bad judgment or one with a blameless addictive disorder? In the past year, this question has presented itself with dependable regularity. Most famously, Tiger Woods received sex-addiction treatment last winter after he admitted to infidelities; at least a dozen women came forward to claim they’d had sex with him. The chronically undisciplined Charlie Sheen recently sought help in controlling a variety of runaway appetites, including a fondness for the company of porn actresses. Earlier this month, Republican Congressmen Christopher Lee resigned after he was caught e-mailing a shirtless photo of himself to entice a woman he met on Craigslist. And then there is Silvio Berlusconi, the uninhibited Prime Minister of Italy, where prosecutors want him to face trial for accusations that he paid an underage girl to have sex with him. Berlusconi has never hidden his partiality to beautiful women, but he has called the allegations — and reports of louche parties at his villa — politically motivated. All these cases differ in scope, but a central question remains: Why would these men risk everything to satisfy their urges?

When it comes to addiction, the line between morality and disease has always been blurry. But only in the past 25 years have we come to regard excesses in necessary cravings — hunger for food, lust for sex — as possible disease states. In 1983, when Melinkovich was continuously cheating on his then wife (an actress from Planet of the Apes), a Minnesota-based addiction-treatment organization called the Hazelden Foundation published a foundational book called Out of the Shadows: Understanding Sexual Addiction. The book, which is still in publication, helped create the field of sex-addiction treatment. Its author, Patrick Carnes, is now executive director of Gentle Path, the sex-addict program Woods is said to have entered last year in Hattiesburg, Miss. (See a brief history of the Tiger Woods scandal.)

The American Psychiatric Association (APA) is debating whether sex addiction should be added to its Diagnostic and Statistical Manual of Mental Disorders. The addition of what the APA is calling “hypersexual disorder” would legitimize sex addiction in a way that was unthinkable just a few years ago, when Bill Clinton’s philandering was regarded as a moral failing or a joke — but not, in the main, as an illness.

APA recognition of sex addiction would create huge revenue streams in the mental-health business. Some wives who know their husbands are porn enthusiasts would force them into treatment. Some husbands who have serial affairs would start to think of themselves not as rakes but as patients.

This is already happening. In the year since Woods made sex addiction famous, rehab facilities accustomed to dealing with alcoholics and drug addicts have found themselves swamped with requests for sex-addiction treatment. The privately held company Elements Behavioral Health, which operates high-priced rehab centers around the U.S. — including a celebrity-friendly one on a breathtaking mountainside in Malibu, Calif. — recently acquired the Sexual Recovery Institute, a Los Angeles center for sex addicts. The institute’s revenues grew 50% in 2010.

But the legitimacy now being granted to sex addiction requires a closer look. In the 20th century, we changed our thinking about alcoholism: what was once a moral weakness came to be understood as an illness resulting in large part from genetics. Sexual acting out seems different, though. Is excessive lust really just another biochemical accident?

See more about what happens in sex rehab.

It’s bad enough when your parents, friends and plain old budinskis tell you to stick out your marriage, but now the Feds are getting in the act. Walk though a subway car and you might see a poster that shows a couple lying in bed. Mouth wide open, he’s snoring away and she, well, she’s clearly making the best of it.

So what’s behind this story? The subtext is the ad was paid for by the U.S. Department of Health and Human Services to encourage couples to work on their relationship. According to Metro New York, the posters appeared on mass transit systems in New York, Atlanta, Los Angeles, Chicago and Washington, D.C. The ads direct commuters to a website called TwoOfUs.org that is run by the National Healthy Resource Center (NHRC). TwoOfUs dispenses tips on dating and advice on meeting the challenges of family.

I visited the site and watched a video excerpt of an interview Michelle Obama gave on the Today show. The First Lady was quick to say that she and the President did not want their marriage to appear flawless. Every marriage, she noted, has its ups and downs. Living apart can take its toll. To keep romance alive, she suggested other couples follow their example and institute a date night. Carving out space from the pressures of everyday life, getting away from the kids, the television or any other distraction and focusing on each other makes sense — although it struck me as another stimulus initiative.

Now I’m not knocking the NHRC or the government’s high-mindedness. There’s nothing wrong with having a national clearinghouse for information and research that helps troubled couples preserve their marriage. I’m just wondering why the government has such a vested interest in marital bliss. Then it struck me. Aside from the obvious social and psychological advantages — love, companionship, sex — there’s an economic upside to marriage that is spelled out on the TwoOfUs website. It reads:

“Apart from the initial divorce-related fees, divorce can also have negative long-term financial consequences. Marriage is one of the best defenses against poverty. The poverty rate for children in married-couple families is around 8 percent. In single-parent households, the child poverty rate is around 35 percent. That is not to say you should stay in a truly unhealthy relationship for purely economic reasons. But before you write your marriage off as a total loss, be sure you have accurately calculated the costs–both financial and emotional–of divorce.”

So, from the government’s perspective, it’s a matter of dollars and cents. More divorce, greater risk of poverty, ergo Uncle Sam has to shell out more in public assistance programs. And we certainly cannot afford that, not with all the other tabs we’re running up.

I’m not sure putting up posters is going to make an impact on lowering the divorce rate. It’s sort of like Nancy Reagan’s naive approach to solving the drug problem — Just say no. But I do have a suggestion that might add to our coffers. Sell the poster. I know plenty of women who wouldn’t mind putting it up over their bed to remind their Prince Charming there are grounds for divorce they hadn’t considered.

He snores? Get over it. Maybe we can; maybe we can’t.