Is the DSM Nasty?

Less than a year now til the next DSM comes out..where do you stand? An evil book that pathologises people or a helpful diagnostic guide?

Just met with a student today who may end up looking at how clincians from a variety of professions compare when it comes to using the DSM, particularly how they resolve any ethical dilemnas that may arise from working ion mental health services that may demand its use.

Ive been very interested to read this critique, a strident one.Zur, O. and Nordmarken, N. (2010). DSM: Diagnosing for Money and Power" Summary of the Critique of the DSM. Retrieved month/day/year from http://www.zurinstitute.com/dsmcritique.html.

DSM: Diagnosing for Money and Power
Summary of the Critique of the DSM

Ofer Zur, Ph.D., and Nola Nordmarken, MFT

below is an exerpt..

Labeling normal behaviors as mental disorders financially and professionally serve psychotherapists of all theoretic orientations. Following are some examples of how the DSM turns normal behaviors and temperaments into mental illness.

• Shyness or normal introversion can be diagnosed as "Social Phobia."
• The individual process of healthy grief might be diagnosed as "Complicated Grief Reaction," if it lasts a tad longer that the amount of time specified in the DSM.
• Healthy, strong willed or active children are often diagnosed as having "Oppositional Disorder."
• Children who are restless, non-compliant or not academically oriented are diagnosed with "ADHD."
• Meaningful and healthy existential angst might be diagnosed as "General Anxiety Disorder" and medicated away.
• Those with feelings of hopelessness and despair related to the burden of social injustice and poverty might be diagnosed with "Depression."
• A person who attributes spiritual meaning to a powerful insight could be diagnosed as "Delusional."
• A woman who is not sexually aroused in relationship to an emotionally disconnected partner could be diagnosed as having "Female Arousal Disorder."
• Feeling jittery and agitated from drinking too much coffee can be diagnosed as "Caffeine Related Disorder."
• People, who for reasons of being abused, stressed, uninspired or who simply choose not to engage in sexual activity, are diagnosed as having "Hypoactive Sexual Desire Disorder (HSDD)," which is described in the DSM-IVTR. This disorder is characterized by a low level or absence of sexual fantasy and desire for sexual activity. The obvious question is, "Who decides what is a low level?"
• "Gender Identity Disorder (GID)" is another culturally biased diagnosis in which any behavior that does not fall within the rigid confines of the narrowly defined and preferred sex roles prescribed by most modern western cultures is pathologized. Consideration of normal developmental phases, playfulness and individuality are often harmfully discounted in this restrictive application of diagnostic criteria.

Don't Be a Messenger Boy/Girl: Independence in Research Relationships

Was involved in a meeting today to design a new project that made us all think about the need for independence when conducting research...the project is one instigated by a large well known branded treatment group who want to look at whether or not their approach will be suitable across cultures..

The project has the potential to do so much good and those instigating it demonstrate a sound commitment to improving lives and a prolific entrepreneurial ability but what emerged was the need for us to bracket off design, recruitment, data collection and dissemination in a way that maximises our independence from their interests, be them imagined or otherwise....

Many qual researchers will find themselves involved with branded treatments at some point in time...often qual researchers can do a great job latching on to RCT's for example, to uncover the subjective experience of participants, thus enriching and triangulating quant findings..we need to be careful though that these studies are truly exploratory rather than allowing for any bias unconsciously seeping in from the juggernaut of an established branded treatment..(see prior post on Situational Analysis)

Are we storytellers and artist-scientists?

The most beautiful thing we can experience is the mysterious. It is the
source of all true art and science.
—Albert Einstein

I love coming a cross an inspirational article and today it was Intuition and Creativity: A Pas de Deux
for Qualitative Researchers by Valerie J. Janesick of Roosevelt University (Qualitative Inquiry, Volume 7 Number 5, 2001 531-540) (LINK)


At the heart of her argument is , I am trying to shift the conversation about qualitative research methodology and design from the “McDonaldization” or “Disneyfication” of method and design to an understanding of the intuitive and the creative.


Technique is one thing but if we are really going to discover something novel we need to go beyond the technique and be creative....


Heres another great one...Creativity within Qualitative Research on Families: New Ideas for Old Methods by Sharon A. Deacon ⁺The Qualitative Report, Volume 4, Numbers 3 & 4, March, 2000 (LINK)

She puts forwards art, poetry, timelines, writing exercises, photo projects to gather data..

Here is an excerpt..

Writing Exercises

When we think of using writing as a method of qualitative research, we usually think of open-ended questions on a survey. However, there are other writing activities researchers can use that are not ordinary or monotonous to gather information from participants. Researchers can ask participants to keep journals of their daily activities or feelings, and then use these journals as one way to understand and describe participants' and their lives (Symon, 1998). Researchers can also request that participants keep logs of certain activities, memories, or dreams as a way to gather information.
Incomplete prompts are words or beginnings of sentences or stories ("prompts") that researchers can ask participants to finish with their own ideas. With incomplete sentences, researchers ask participants to fill in their thoughts for a list of unfinished sentences that relate to the topic of study. For example, "When I was in the hospital, I felt. . ."; "The hardest time in my life was. . ."; "The turning point was when. . .". Researchers can also give participants topics to write on or titles for stories and then ask participants to use their creative writing skills to write the story. In studying rural farm families, a researcher might ask the family to write a story on "The challenges of farm life that most people never realize." Or, to study reactions to a devastating flood, a researcher might ask participants to tell a story titled, "Lessons for Recovering." Finally, researchers can ask participants to write about headlines in newspapers that reflect current events ("The Future Direction of Our Community" , "One Family's Reaction to the Tragedy"), or classified ads for specific desires ("Perfect Parent Wanted: Qualifications:. . .", "Perfect Job. . .", etc.). 


This paper is chockers full of practical ideas

Sneak Peak: Can Talking About Your own Childhood Make You a Better Clinician?

Just sending of a new paper, based on research conducted by a Doctorate student and many other collaborators..the study basically aims to answer the question as to whether or not reflective supervision, based on the clinicians family of origin, containing NO case material, helps make for better clinicians? This a pretty important debate given our tradition of giving psychoanalysts massive therapy vs the competency-based focus on much on clinical psychology training. There is certainly a push, especially in the Uk for personal development to be included in Clin Psych training, but we are lagging here downunder in this respect..

Family of Origin Coaching for Clinicians in a Tertiary Adolescent Mental Health Service

 Abstract

Background. The role of the therapist as a person rather than only as a technician has become increasingly important in family therapy since the post-modern turn. Despite this there is a paucity of research exploring supervision models that focus on self-reflection, as opposed to clinical competence. Method. This study documents the experience of a Family of Origin Coaching group, conducted with six clinicians and one supervisor working in a tertiary adolescent mental health service. A participatory action framework was used, with data analysed using grounded theory. Results. A variety of benefits were reported, including personal development, an enhanced empathy towards clients and an ability to better cope with stressful team dynamics. Conclusion. Family of Origin coaching has the potential to yield benefits for clinicians as a compliment to traditional supervision. Issues of confidentiality and safety need to be addressed carefully, especially during times of organisational change or stress.  

Here are a few choice photos to illustrate the point?

Perfectionism Central?

I went to a school HSC prep night tonite for one of my kids and was very interested to hear what the careers advisor had to say about us...basically that when she visited the speakers was so busy telling them that we were the best university in Sydney that all the careers advisers were put off and swore never to return....they really wanted to hear that our uni had its place and how it was unique but they felt all they were getting was a competition where we thought we were at the top... embarrassed :(

I fits in with alot of my thinking recently about academic culture and the messages we can send out to students...are we really interested in their development as individuals? Is the academic narrative superseding the intellectual one? Is space made for the students voice on campus? If all we care about is being the best on a league table rather than pursuing excellence for its own sake arent we risking alot? I know this must be obvious to most but its taking a while for my rose colored glasses to come off..........

On the positive side I confess to being  impressed by the culture of openness in Psychology...we are happy to have qual stand alongside quant, to have psychodynamic thinking stand alongside CBT, reflective practice alongside the scientist practitioner model...im proud of the fact that we are being rigorous, having very high standards but also encouraging our students to think and individuate during the course..

Your thoughts?

Voice of Dissent- Australian Universities: A Portrait of Decline Dr Donald Meyers

This book is an insider's account of the current state of Australia's universities. It paints a picture of a system driven by the balance sheet, administered by a mindless and mean-spirited bureaucracy, adrift in a mire of pedagogical pap peddled by Educationalists.

It is the story of the transformation of our higher education system from one that delivered a rigorous education, producing highly competent graduates, many of whom distinguished themselves on the international stage, into two-dollar-shop degree factories. The resultant threat to the broad-scale competence of the professions is obvious.

In spite of policies for everything: Quality Assurance, Graduate Attributes, Personal Performance Plans, KPIs and myriad managerial fantasies, the fall in standards is undeniable and the extent of institutional dysfunction is staggering. Students, parents of students and graduates are scarcely equipped to critically examine the assumptions underlying these "reforms" and the ensuing impact on education. One of the aims of this book is to redress that shortfall.

Not only are university and government education bureaucrats presiding over the destruction of the intellectual fabric of the nation in an era of unprecedented global competition, they are denying a genuine higher education to those Australians with the necessary intelligence, motivation and practical skill to succeed.

Link to Bookhttp://www.australianuniversities.id.au/

Research Farming? Here's a Great Way to Learn N-Vivo!

If you want to learn NVivo, take time out to work on your analysis, meet other researchers  Im highly recommending Dr Pat Bazeley's Research Farm as a great service to consider......(this is unsolicited by the way, i have attended her workshops many years ago) Located on 10 acres in the beautiful Southern Highlands of New South Wales, the Research  Farm is designed as a respite and retreat centre for researchers who need to take time out for concentrated writing or data analysis. It is also ideal for those who just want to spend time  thinking about, talking through, or working on their research.

“The Research Farm and Pat are an unbeatable combination... Finding an environment that develops my thinking, nourishes my body with superb cooking, and refreshes my spirit with opportunities to pick fresh berries, strawberries and collect the eggs - all while engaging in stimulating conversation and debate - is a blessing. These, combined with Pat's generosity in sharing her time, knowledge, expertise and wisdom make the research farm an invaluable find!” (Susan, after a five day workshop).

Excellent recreational and leisure opportunities exist in the Southern Highlands, should you need a break from work. There is an abundance of good coffee, craft, antiques and bookshops in the area, and opportunities for walking or cycling.

Email: pat@researchsupport.com.au Ph: +61 2 4862 3026 Mail: 3 Old Bong Bong Way Burradoo NSW 2576