You can recover from your mental illness

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Woman crying with alcohol

Mental illness
Photo courtesy of Pixabay.com

Recovery happens – Does that surprise you?

Mental and emotional illnesses are relatively common.

Some of you are denying that you have or could ever get a mental illness. Half the population at some time in their life will have a mental illness. Depression and anxiety problems are the most common but many other emotional problems can throw you for a loss.

Among those who do develop a mental or emotional disorder, the conventional wisdom has been that they are “seriously and persistently” mental illness. The implication, all too often, has been that once you get a mental health diagnosis then life is over for you.

Recovery happens.

The truth is that many people do recover from their mental illness. Some by using professional help and others recover in spite of the obstacles the system puts in the way of recovery.

Before the discovery that medications could help with mental illness, the prevailing thought was that the mentally ill were “Crazy” and that once you “lost your mind” it was unlikely you would regain it. This has turned out to be untrue.

Medication can help.

For some, but not all, medication has completely changed the prognosis of mental illness. If a few days on medication can restore someone to functional behavior then it is clear that having a mental illness is not an incurable condition.

We have also discovered that many of the things we used to consider mental illnesses were the result of a lack of skills. People who did not learn good social skills in childhood find it difficult to have good relationships in adulthood. The good news is that anything you learned incorrectly can be unlearned and that the human brain is never too old and rarely to sick to preclude the chance of learning new material.

The consumer movement emphasizes recovery.

One other factor has challenged the notion that once mentally ill, forever sick. Because of the stigma, the mentally ill have traditionally faced many people hid their diseases. More and more of those who have had a mental illness have come forward to talk openly and honestly about their struggles. This openness is sometimes referred to as the consumer movement.

It has become clear to me and to others that there are many highly functional individuals who have at one point or another in their lives have struggled with a mental, emotional, or behavioral illness.

Unfortunately, discrimination against the mentally ill continues to keep people away from treatment.

In truth, half of all Americans are likely to experience one or more episodes of mental illness in their lifetimes. Those fortunate enough to have a strong support system and willing to seek treatment can and do recover.

Many a tragedy, personal and public, might be averted if more people could be encouraged to go for treatment rather than trying to hide their symptoms and pretend to themselves and others that they were not struggling with a mental health challenge.

Put an end to the lie – let people know – recovery happens.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

It doesn’t have to be true for you to believe it

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Truth or lie

Separating truth from lies is hard work.
Photo courtesy of Pixabay.com

Just because someone believes it does not make it true.

We continue to see a lot of conflict and violence over differences in beliefs. It is hard to understand how different people could look at the same set of circumstances and come to such very different conclusions, but they do.

People can become pretty heated about the big stuff, politics, and religion, but progressively smaller things, like sports teams and physical appearance, can result in huge disagreements also.

Don’t think there is a correct way to look.

Would you kill someone or kill yourself because one of you is too tall or too short? How about being too fat or too thin? Just those sorts of beliefs are resulting in bullying, violence, and self-harm. Some of these bullying incidents have resulted in suicide even when the statement the bully made was clearly incorrect. The problem was that the victim believed something that was not true.

Being bigger or smaller, smarter, or less smart are not reasons for harm to others or self in my opinion but that is the topic of another post.

What we are seeing daily in the news is the way in which people who are told lies about themselves come to believe those lies and then take action based on those incorrect beliefs.

In counseling, we see a whole lot of people who are convinced they are too fat or thin, stupid, or ugly when the evidence in front of the counselor’s eyes contradicts that belief.

Do not believe everything you think.

Most of us fall into the trap of thinking that because we believe something, that is evidence that our beliefs are true and that others should quickly see the error of their ways when they do not agree with us.

What if some of your most firmly held beliefs turn out to be untrue?

One way in which incorrect beliefs come to be regarded as true despite no evidence or evidence to the contrary is called emotional reasoning.

If you become scared when you think of something, you could take that as evidence that the thing that scares you is dangerous.

Many of us fall into the emotional reasoning trap when we chose to believe something because it makes us feel better or more secure if that were true.

This is a way the bullies of the world torment their victims. They express a negative derogatory statement about their victim and then because others say something about you the victim is driven to believe the things the bully has said.

Many a person will make statements in your lifetime, some of them derogatory. Those comments from others do not make them true. And even if there is some grain of truth in them, remember the best lies contain just enough truth in them to be believable.

The opinions of others ought not to matter. Clearly, many of the things others say are not true. You don’t have to believe everything others tell you and you do not need to believe every negative thing you think about yourself.

Be very careful that you are not lying to yourself. The most hurtful lies are the ones we tell ourselves so often that we begin to believe them.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

The only two must-have things

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Happy children

Happy.
Photo courtesy of Pixabay.com

What two things are “must-haves?”

From my time as a counselor I find that there are two things, clients must have to create a happy, fulfilled life. Those two must-have things are not the things we have been led to believe are must-haves for happiness.

Whatever their challenge in life, my clients all seem to be missing two important ingredients to create a happy successful life. People who hear voices and see things and people who thought they were perfectly normal until life took a wrong turn both need those same things.

Humans as biological organisms need some minimal intakes to sustain their biology. We need some food, some water, air to breathe, and a small amount of clothing or shelter. Mostly though, as warm-blooded vertebrates, we adapt. Not having those things risks your health and life but having them does not automatically make you happy.

Happiness is not things.

America is blessed and cursed with an abundance of things. So many things we have to haul tons of them to the landfill each week just to keep our things from choking off our access to the remaining things and still – will all those things, we are not happy.

We live in a land of plenty and more people here suffer from excesses than from shortages. There is too much food and the result is obesity and diabetes. We have plenty of vehicles and we consume humongous quantities of energy in our pursuit of happiness and still, amid all those excesses we can’t find happiness. Americans consume the lion’s share of drugs and alcohol and still, we can’t arrive at happiness.

What then are those two things that appear vital in the creation of happiness whether you are rich or poor? Despite our unending search for therapies to help people with their depression two things consistently improve the depressed person’s mood, a healthy relationship, and a purpose in life. Both of these things while simple, are harder to do than they sound.

Humans need healthy relationships.

By this, I do not necessarily mean romantic or sexual relationships, though having a close romantic partner seems to make most warm-blooded vertebrates happy.

We need a relationship with other humans and we need relationships with those higher powers most of us call God or a Deity.

It is a difficult task to have a healthy relationship when you are emotionally sick. Many people find they need to develop a healthy relationship with themselves before they can have a healthy relationship with another. Falling in love is intoxication but the stupor soon wears off and you begin to see with clear eyes that not all love relationships are healthy.

You do need a meaningful purpose in life.

For most of us, this is some form of work. We have come to recognize that many people who we used to think were not capable of work, can despite those challenges we call disabilities, engage in meaningful work.

All work does not need to be paid employment. Having a task that brings meaning to your life gives you a reason to get up in the morning. So paid or volunteer, of someone else’s choosing or of our own, having something to do each day that aligns with a purpose or goal gives us hope and happiness.

You may not be rich but if your daily tasks have a higher purpose, doing God’s will or giving to others, you are most likely to find happiness in living those life purposes.

Finding a job is difficult sometimes. Finding a career that gives you more than just money is more complicated. The more you like your work, the more you are doing what you feel called to do the greater your happiness. No amount of money can compensate you for doing something that is not worth the effort.

We all may need to do something from time to time to pay the bills and keep the body and soul together but in the long haul we call life, those who can find a purpose and then find a way to earn a living at that purpose are well along the road of happiness.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

You can become a “natural”

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Skills.
Photo courtesy of Pixabay.com

Can you learn to be a natural?

When it comes to ability there are two schools of thought.

One group says that people are either born with a talent or they are out of luck. This used to be the prevailing theory. There are still a lot of folks who cling to this notion. They would have us believe that some folks are born to be poor, stupid, and uneducated and other people are born to be rich, privileged, and perfect.

The other school of thought decrees that people are all born with some genetic abilities but how those talents grow and develop are heavily influenced by the training they receive and the skills they develop.

School one says that if you are clumsy, that is the way you are and you will be clumsy the rest of your life. Coaches from this school search far and wide and try to recruit talent for their teams.

Coaches from the second school, the incremental skills school, look for ways to help the players they have developed more and better skills.

Personally, I think there is strong evidence for the second school. People who initially did not look like they could do something can often outplay, out study, and outperform those people who initially looked like “naturals.”

Naturals are developed over time not born that way. Some people who should have made the natural list never got the training they needed and as a result did not become the “natural” they could have become.

Some examples.

We expect that the tallest people should be the best at basketball. Yes, good players often enjoy the benefits of being above average in height, but have you ever known a really tall person who just could not play basketball? Are their short people who turn out to be extraordinary players? Appearances do not make for naturals and neither do inborn qualities.

The college degrees often do not go to the smartest people. We all know plenty of really smart people who did not apply themselves and as a result, failed to finish their education. Education does not always equal ability or opportunity but in many areas of life, without education, you don’t get to play the game in the first place.

“Naturals” practice – a lot.

If high levels of ability were all about being a natural, those top players would never need to practice. The truth is that the best players practice repeatedly until the things they want to do become automatic actions. They train themselves until they become that “natural” they wanted to be.

You have to practice the things that need improvement.

Highly successful people do not focus only on the things they do well. The difference between the top athletes and the next level down is that the top people continue to practice the things they do not do well until those things become part of their A routine. Those people who aspire to greatness but never make it often look for the things that they are good at, the things that they think reflect some natural ability, and then they practice what they are good at. Maintaining skills by practice is a good thing, but failing to improve yourself will prevent you from reaching the goals you would like to achieve.

The best way to be cone a natural is to find something that is an underdeveloped talent and practice this until you become proficient at it.

What thing would you like to look so good at that people would think you were a natural at it? Are you willing to work and practice until you become one of those high achieving people?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Is relapse a part of recovery?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Relapse

Relapse.
Photo courtesy of Pixabay.com

Is relapse a necessary part of recovery?

You will hear this a lot if you hang around treatment facilities, even self-help groups. I suppose it comes from seeing people relapse and feeling helpless to prevent those relapses. But is relapse really a necessary part of recovery?

Mostly this is applied to substance abuse, drugs, and alcohol, but more and more we are seeing that other emotional, mental, and behavioral challenges can follow the same processes. People get unhealthy; they may get sick and then they recover.

Do symptoms have to get worse before they get better?

Every time one of my colleagues says that relapse is a part of recovery I cringe. It feels like saying that heart attacks are a part of treating heart disease. I do not believe that good treatment should accept any negative outcome as a part of the recovery process.

Relapse is common, but it is not universal. Some people, more than you might think, recover, and never relapse.  A surprisingly large number of people report that they were able to quit drugs, get over their depression and anxiety, and stay quit and recovered.

So how do they do recover without relapse?

We need to talk about several things. What is recovery, what is relapse, and how do people go about changing?

Emotional challenges and substance use problems are a lot like chronic physical disorders. If you have had a stroke there has been some damage done. If you have been diagnosed with diabetes you will never be “cured.” Some changes will always remain as a result of your experience.

While you will never be “cured” you can, and most people do, recover from that disorder. The same thing happens to those people who have had an emotional or substance use disorder. They can and do recover but they are never fully cured. There is a risk that if they are not careful they may slip back into an active stage of their problem but if they are vigilant about their recovery they do not need to keep getting sick again and returning to their provider to, again and again, be treated and recover over and over.

These ideas about substance use problems and mental health problems are both included in the The Big Book of Alcoholics Anonymous. Bill W. wrote about the issues that those with Bipolar Disorder will face that may make their recovery more difficult than that experienced by people who do not have an underlying mental health disorder.

Bill W also wrote that in the early days of those who came to the program and stuck (meaning actually continued to attend and participate in the program) 50% quit drinking forever. That does not sound to me like he believed that relapse needed to be a part of recovery.

He went on to report that of the remaining half about 25 % had to quit a few times to get it right but those people did eventuality stop for good.

What about that last 25%? The big book reports that while some people never did manage to stay stopped those people, while attending A.A. were much improved. I take that to mean that while the treatment for a mental or emotional problem may not fully effect a cure, reducing your symptoms is a way to reduce the harm that a mental, emotional, or substance use problem creates.

These days we are applying the stages of change model to both mental health and substance use disorders. Take a look at some of the books on how people change such as Changing for good.

Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward

I have written posts in the past on this model and how it can help you change and stay changed.

In this model, we see that people need to recognize they have a problem, gather information, get ready to change, and then go through the process of making real meaningful changes in their lives. In this model, we see that maintenance, those things you need to do to stay changed once you have made a change, those maintenance steps are the key to preventing relapses.

Relapse is a failure to maintain recovery.

Relapse is not a part of recovery, but the result of failing to continue doing the things that helped you get better in the first place. Whatever you did to get your emotional problem or substance use issue in remission in the first place, those actions need to continue to be a part of your life if you want to insure yourself against relapse.

If you do relapse, do not beat yourself up. Get back into recovery and practice the things you need to stay well. Just know that repeated relapses do not need to be a part of recovery if you practice your maintenance program.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Top counselorssoapbox.com posts for Sept 2013

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Counselorssoapbox.com

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Well, the month is not quite over but here they are the most-read posts on counselorssoapbox.com for the last 30 days, just in case you missed one.

How much should you tell a therapist?                     

Levels or types of Borderline Personality Disorder               

Do therapists have to report a crime?            

Hyperthymia, Hyperthymic Personality Disorder and Bipolar Disorder                   

Do people really forget what happened when drinking? – Blackouts                       

Which border is Borderline Intellectual Functioning on?                  

Reasons Counselors and Therapists Lose Licenses               

Are you Hyperthymic?                      

6 ways to recover from Complex Trauma or Complex PTSD                       

Is nicotine a stimulant or a depressant?                     

Do therapists like, fall in love with their clients? Why don’t they tell them?           

Can you force a teenager to go for therapy? 

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What are evidence based practices?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Update on the national registry of evidence-based programs and practices, 2/19/18.

SAMHS recently sent out a press release saying please disregard the National Registry of Evidence-based Programs and Practices.

The new administration questions whether some of these programs and practices listed there were added without much real evidence. The original post follows.

What are evidence-based practices?

How many evidenced-based practices are there anyway and why should you care? Should you care if your counselor or therapist is using an evidence-based practice, and what are those things anyway?

The talking cure and case studies.

In the beginning of psychotherapy, it came as a shock that just talking could help someone. Freud came up with a whole lot of ideas about how and why things were creating problems for clients. If you see early childhood sexual conflicts and the unconscious as the source of the patient’s issues you go in one direction.

So as the practice of psychotherapy grew, those practitioners, often called analysts, started trying all sorts of interventions. Some worked and some didn’t and often we had no idea what worked, for whom, and when.

Analytical psychotherapists started writing up case studies about clients they had treated. Then other psychotherapists tried similar interventions and often got different results.

How are we to know what works when? Is it the characteristics of the psychotherapist, the client or the intervention that is causing the results we see?

When someone else pays they care if your treatment is working.

If you are paying for your treatment then you can see whomever you want, but as there became more government and insurance funding we need a way to check and see if what others are paying for is really worth the money.

Some therapists, particularly Cognitive-Behavioral Therapists, believed that if a technique is valid then it should work most of the time and no matter who did the technique. That notion has spurred a lot of research.

What we find is that the larger the group in the study the more reliable the results of the study, all other things being equal. So more and more theories have been studied in larger and larger trials. We are starting to see that some interventions work most of the time, for most people, when the therapist does them correctly.

One way to further this process has been to create a “National Registry of Evidence-Based Practices.” New interventions, treatment manuals, etc. are registered here and as the research is conducted it gets added to this database.

SAMHSA (Substance Abuse and Mental Health Services Administration created a National Registry of Evidence-based Programs and Practices.  

Currently, the registry contains listings for over 300 different programs and practices that are registered and for which reports and evaluations are available. Some of these treatments are much better than others. Some treatments have a few or only one study showing they worked. Other treatments have hundreds of studies and thousands of clients and are much more recognized as worth the cost.

Over time we should be able to see what works and what does not. Understand that no treatment or intervention is guaranteed to cure every client every time. But some treatments are clearly worth their costs and others are rarely of value.

Also, consider that it matters who did the research and how many people were in the sample. A study of two friends does not mean as much as a study of 10,000 randomly selected clients. Not every counselor has the same level of skill. So in evidence-based practices, it would be reasonable to emphasize treatments that are “manualized,” meaning that there is an instruction book and we can see if the therapist is actually giving the client the treatment that is prescribed by a particular evidence-based practice.

While not all evidence-based practices are equal and some of those on our current list are sure to fade away with time, this system of asking practitioners to prove that what they are doing for or with clients is beneficial to those clients is certainly a huge step forward.

A program or practice inclusion does not necessarily mean that a practice works or that it will work all the time with every client. What it does mean is that these programs and practices have documentation to tell others how they should be conducted and research to document when and where they have been effective or not effective.

SAMHSA notes that “NREPP is not an exhaustive list of interventions, and inclusion in the registry does not constitute an endorsement.”

Whatever the drawbacks having a place where providers can go to look for programs and practices that may be helpful in designing treatment programs is hugely helpful in moving the mental health and substance abuse professions forward.

There was a time not that long ago when each place was doing their own thing sometimes with good and sometimes with poor results. We now have better ways of establishing that the treatment provided is generally effective in treating a particular condition.

Some of the programs included in the registry are expensive to get trained and certified and others are free or nearly so. Clearly, some practices were listed by their originators to sell more books and trainings; others are listed because the developer wants people to try them and to promote research. A few of the programs were developed by SAMSA or other government programs and the materials are all available to download for free.

A quick scan of the list came up with some treatments worth looking into.

Brief Marijuana Dependence Counseling

Mental Health First Aid

Seeking Safety

Take a look, and let me know what other Evidenced Based Practices you find interesting.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Bath Salts visit the ER

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

New drugs

Bath salts.
Photo courtesy of Pixabay.com

ER’s saw an extra 23,000 people as a result of Bath Salt use.

More Bath Salt users are going to the hospital.

People having an adverse reaction to taking “bath salts” are on the rise. For the uninitiated, these are not something you find in a boutique home store. Sold under the name “bath salts” these chemicals are being used in an effort to get high.

These chemicals are labeled “not for human consumption” in an effort to avoid detection and regulation. Anyone selling these chemicals must know full well that customers are smoking or injecting these drugs.

Now SAMSA is reporting that in 2011, the most recent year for which we have statistics, the number of ER visits in which bath salt use figured has reached 23,000. Many of these are in combination with alcohol or other drugs.

I have seen some clients who appear to have suffered a long-term consequence as a result of using bath salts.

To keep all this in perspective, that same year, 2011, drugs were involved in 2 ½ million hospital emergency visits.

Treating Bath Salt overdoses cost money.

At a time when we are looking at the high and rising cost of medical care, it is hard to overlook the huge consequence of drug use and abuse.

While bath salts are down the list of ER visit causes, expect the costs to society from abuse of bath salts to continue to rise.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Why looks matter.

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

dirty hand

Want him cooking your food?
Photo courtesy of Pixabay.com

Is it fair to judge others by the way they look?

Repeatedly I hear and read that we shouldn’t judge people by the way they look. I know people say that because I have said that myself. But the truth is that most of the time, most of us do judge others by the way they look and there just might be evolutionary reasons why we should go on doing it.

Men and women with tattoos or piercings say it is not fair that they do not get jobs because of their body art. In the 1960’s we said that about beards and long hair. Still, people judged anyone who looked different then and now.

Women complain that we judge women by their bodies and not by what is in their heads. Still, we, men and women, spend a fortune on trying to look good to attract and impress the other sex.

When you wander through the jungle it is helpful to seek out other humans and avoid non-humans like bears or lions and tigers. It is not just humans that do this. Birds flock together by species, looking for a mate, looking for protection.

Consider these times when you might want to judge someone by their looks.

You go for a first appointment with your new doctor. The person at the front desk is sipping on their beer and looks like a homeless bag lady. What is happening here? You get into the exam room and the nurse who comes in to take your vitals is wearing some torn, bloodstained scrubs. When the doctor arrives he has on an old sleeveless tee-shirt and some cut-off shorts. He has grease all over his shirt and hands like maybe he was working on his car between patients.

So how comfortable are you feeling now? From the diplomas on the wall, this person went to a big name medical school. Still, his appearance is not too reassuring. Is it fair to judge him by his looks? Are you willing to risk your life and your medical care to someone who looks like a part-time doctor and a full-time auto mechanic?

Lots of clients tell me it is not fair that they get judged by the way you look. But if you want a job at that bank you might want to lose that “but-wiser” tee shirt and the sagging pants for the interview.

Psychological studies tell us that people tend to like others who are like themselves. This is not specifically related to race. It applies to a lot of other characteristics.

Say you walk into a bar and you are wearing your favorite team tee-shirt. Everyone else in the bar is wearing the shirts for the other team. How safe are you feeling now? Want to hang out and give them a chance? Maybe. But consider that humans, like most other animals, are constantly looking around to see how others look and how they behave. Then we either copy those others or we leave. Staying and not conforming risks being attacked, verbally, emotionally, or physically.

Consider another example.

You move into a new neighborhood. All the kids there seem to be wearing red shirts. You take your teen shopping and they insist on buying a blue shirt. They say they love Navy Blue. So you give in. Then the problems start.

Gangs use clothing styles and colors to identify who is “in” and who is “out.” I am not saying this is right, but do you want your child killed in a drive-by just because they insisted that they wanted to wear what they wanted to wear, and others should accept them.

I am not endorsing this judging behavior, just that there are a whole lot of situations where you can and should judge people by how they look and rest assured that others will judge you that way whether you like it or not.

So if you want to stay safe or get that job, consider that sometimes you need to conform if you want to get along. The older we get the less satisfying it is to say others should or should not do something. I can’t change other’s attitudes but I can put on a suit and tie before that job interview.

Sometimes how people look can tell you a lot about who they are on the inside and whether you want to be around them given the choice.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Why you should judge a book by its cover

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Books.
Photo courtesy of pixabay.

Ever heard the old saw “Never judge a book by its cover? Turns out that most of the time we should be judging books by their covers.

Let’s start by considering two literal books, both presumably about economics and how to respond to economic problems.

Book one is titled “How to make money in a bad economy.” The author’s name is “A working girl” and the cover depicts an attractive woman in a negligee holding a large fanned wad of cash.

Book two is titled “The history of recessions, depressions, panics, and commercial revulsion’s in the United States from 1640 to 2008, including the role of government’ policy in precipitating financial collapses.”  This second book is written by a well-known economist from a prestigious eastern school. It comes with a very plain cover with the title, author’s name and credentials, and not much else.

Which book should you pick? Do you really need to open the book and read the first few chapters to figure this one out?

If you wanted a steamy sex book, by all means, pick the first book. But if you are trying to figure out a way to plan your financial future you might be better off with book two.

Turns out that there are plenty of times when we should, in fact, judge a book and a whole lot of other things by their cover, so to speak.

You don’t always get the chance to think it over.

Humans are inherently cognitive misers. We only have so much brain space and if we squander that capacity thinking over things that do not require careful thought we will have nothing left to think about trivial things like what to eat and where to live. Think too much about every decision and you will have trouble getting out of bed in the morning.

Now it is possible that these titles are misleading and that one or both do not live up to the promise made by the cover. If you really want to be sure you might open the book and read the first page or two but by then you should have figured out if this is the book for you.

Turns out that there are a lot of other life decisions where the first impression is the right one.

Yes, first impressions can be wrong, but most of the time we form those first impressions based on past experiences, and as a result, we find it easy to make choices that have a high probability of pleasing us.

Too much time spent thinking things over and checking every possibility to avoid a mistake can result in paralysis and indecision.

One other factor to consider is the costs of either failing to make a decision or making a bad decision.

If you are a college professor who teaches economics, you may well go ahead and buy both. Spending more money may be within your budget. But if you are having trouble paying your bills you may read a few pages of both and then decide to pass on both.

This does not negate the principle that sometimes there are plenty of good reasons to judge a book by its cover.

One last thought. In doing that judging you need to look at what the thing is, not how it looks. I have bought a lot of used books in my time. Some had torn or dirty covers some had no dust jacket at all. Still, I could generally tell from the apparent characteristics, the title, the author, and so on, whether this book had merit.

I think this value of judging books by their cover applies to a lot of other life decisions.

But what about judging people by their looks. By this, I do not mean race, but their dress and self-care. Should you judge a person by their outward appearance?

More on the pros and cons of judging by appearance and why we are all likely to do things that way when we are unsure will be coming up in a future post on counselors soapbox.com.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel