Exorcise ,exorcism, voodoo,

[Dancing David]

I hear that and second it! Unfortunately, in the dark depths of our so termed 'progressive' civilisation our most neglected truth is that sufferers of mental illness are swiftly deposited by society into the hands of medical practitioners whom themselves may have not updated their own perspectives.
Still ...the psychiatric /psychological community are in constant debate regarding their own bible (as it were) the highly contentious DSM-V!

Uh, as a mental health practioner for ten years I call you on that. It is crap and false.

"medical practitioners whom themselves may have not updated their own perspectives"

Uh huh, and where are you in 1970? What data do you have? Just your own personal prejudice, obviously Fred Freese and Fisher talk about how to improve the system but you haven't a clue.

I resent your implications and lack of knowledge. So what are the common errors you are talking about? All the psychiatrists I worked with, and that numbers around20 for 15 years did not stigmatize or expect thier patients to not lead normal lives.

So WTF are you talking about, your own personal agenda?

And contentious is not a good descrioption of the deliberative affort to amend and improve the DSM, have you read the DSM-II, or the DSM-III, what about the changes in the DSM-IV and DSM-IVR, what do you think is in error, what do you think needs to be improved. WTF are you spouting nonsense about.

What data and evidence do you have that the mental health field is backwards and repressive.

I say that you are just expressing a personal opinion without a good background in understanding, or you have a personal axe to grind against a specific practioner.

So cite your sources and experience.

We will hash out the value and merits of our views.

Familes are much more repressive than any doctor, i have worked with a lot of people in the mental health system, I started in 1990 and was there when the 'recovery' movement began, here is the probhlem, the 'recovery' movement was already in place. It was all just a bunch of rah-rah for the clients to motivate them.

Doctors stayed the same, case managers stayed the same, the clients changed. We were practicing to encourage opur clients to meet thier needs and lead full engaged lives. What more do you want.

I think you are just spouting crap. Please show me otherwise, where the doctors are backwards and repressive.

Have you ever worked in mental health, do you have a clue, or like Stamenflicker will you blame the mental health system for drug addiction and a lack of social supports.

 

[freudianlip]

My comments were not intended as a personal insult to you ...Dancing David but to incite discourse and debate in the ethos of 'JREF' to discuss skeptism,critical thinking, the paranormal and science in a friendly and lively way!
I have given a few reasons for my comments regarding the DSM, below but as I am in your opinion not capable of spouting anything but crap, I dare not proffer to you an opinion...just give you research based information..

"We have already noted that the political wisdom concerning scientific processes—peer review, informational and critical openness, accountability, citizen involvement, and due process—results in better science. More specifically, patient and family involvement could contribute to greater face validity of categories, not just for clinicians but for patients as well. Patient and family collaboration could improve face validity by addressing stigmatizing language, clarifying the thresholds and boundaries of illness, and identifying the appropriate balance between personal resources and disorder deficits in the consideration of classifications. " That would unfortunately for you include crap spouters like me....??? please follow this link if you would like more information on this; http://psychservices.psychiatryonline.org/cgi/content/full/55/2/133#SEC3Health Care Reform Based on an Empowerment Model of Recovery by People With Psychiatric Disabilities; Daniel B. Fisher M.D., Ph.D. An article suggesting
empowerment for your clients??
Now why research an infallible reference....what...contention.....oh..its a classification issue...who can advise?? perhaps...Robert L. Spitzer, M.D., Chief of Psychiatric Research Janet B.W. Williams, D.S.W., Deputy Chief and Research Scientist VI
Michael B. First, M.D., Psychiatrist: (Research) I
Miriam Gibbon, M.S.W., Research Scientist IV who state specifically;

"Problems with the current DSM-IV categorical (present vs. absent) approach to the classification of personality disorders have long been recognized by clinicians and researchers. These include marked comorbidity among the personality disorders, arbitrary distinction between normal personality, personality traits and personality disorder; and limited coverage (the most commonly diagnosed personality disorder is the residual diagnosis of personality disorder not otherwise specified). "


Please if you can just read this short article
http://wings.buffalo.edu/smbs/acb/neuro/lectures/DSMIVa.pdf

the dementia diagnosis criteria in the American Psychiatric Association’s DSM-IVTR (4th ed, text revision, 2000) have been compared with the World Health Organization’s International Classification of Diseases (10th revision, 1992). Critiques are based primarily on (a) internal consistency and validity of the classification, (b) historical development of the field, (c) conclusions of consensus conferences, and (d) current knowledge and practice. It is suggested that (1) the entire category be labeled "cognitive disorders," to better characterize this group of disorders, (2) there is no longer any scientific basis for the presenile versus senile dementia dichotomy at age 65, (3) Alzheimer’s disease no longer should have unique status as a "diagnosis of exclusion," (4) future manuals should incorporate knowledge regarding the clinical manifestation and course of Alzheimer’s disease and other dementias, and (5) the classification "Pick’s disease" should be broadened to "frontotemporal dementias." DSM-V should incorporate continuing advances in the neuroscience knowledge base and understanding of these disorders. (J Geriatr Psychiatry Neurol 2006;19:137-146
why suggest this????

Flanagan, EH, Author, Reprint Author Flanagan Elizabeth H. Flanagan, Elizabeth H. , Davidson, L, et al.
Issues for DSM-V: Incorporating patients' subjective experiences
AM J PSYCHIAT 164 (3): 391-392 MAR 2007
and....
Fawcett, J, Author Fawcett Jan Fawcett, Jan
Personality disorders: A case in point for DSM-V - Categories versus dimensions
PSYCHIAT ANN 37 (2): 78-78 FEB 2007

You might enjoy this one....
Bracha, HS, Author, Reprint Author Bracha H. Stefan Bracha, H. Stefan , Bienvenu, OJ, et al.
Testing the Paleolithic-human-warfare hypothesis of blood-injection phobia in the Baltimore ECA follow-up study - Towards a more etiologically-based conceptualization for DSM-V
J AFFECT DISORDERS 97 (1-3): 1-4 JAN 2007

and this
First, MB, Author, Reprint Author First Michael B. First, Michael B. , Zimmerman, M, et al.
Including laboratory tests in DSM-V diagnostic criteria
AM J PSYCHIAT 163 (12): 2041-2042 DEC 2006

all available at; http://portal.isiknowledge.com/portal.cgi

if you deem it worth your while..

a taste.....
.....common assumptions about what counts as an adequate category of psychiatric disorder. These dimensions are 1) causalism-descriptivism, 2) essentialism-nominalism, 3) objectivism-evaluativism, 4) internalism-externalism, 5) entities-agents, and 6) categories-continua. Four different versions of the medical model are described and compared with respect to these dimensions. The medical models vary in several ways, but all can be considered "essentialistic." As a counter to the essentialist homogeneity among the medical models, two nominalist analyses of psychiatric classification are reviewed. In order to fill out the space defined by the conceptual dimensions, two alternatives to medical model approaches are also described. After making some suggestions about where DSM-V might best be aligned with respect to the conceptual dimensions, the authors review the distinction between empirical and nonempirical aspects of classification—and argue that nonempirical aspects of classification are legitimate and necessary. cited from; Psychiatric Disorders: A Conceptual Taxonomy by Peter Zachar, Ph.D. and Kenneth S. Kendler, M.D

Thankfully, there are individuals who not only raise issues but suggest solutions, such as;
Beyond Clinical Utility: Broadening the DSM-V Research Appendix to Include Alternative Diagnostic Constructs
Michael B. First, M.D.
Over the past 15 years, researchers have argued that DSM-IV criteria are hindering investigation into the etiology, pathophysiology, and genetics of mental disorders (1–3) and have proposed changes to DSM-V to make it more useful for research. These include moving from a categorical to a dimensional approach more friendly to research (4–14) and adopting a "genetic nosology" that seeks to classify patients into categories that correspond to distinct genetic entities (15). However, because DSM must serve many masters (16), the prospect of including diagnostic constructs useful for researchers but unfamiliar, burdensome, or of unknown utility to clinicians creates a dilemma: how can DSM-V maintain its role as a common diagnostic language facilitating research efforts without seriously compromising its clinical utility?

DSM-V's 'Substance Related Disorders' section: (a) DSM-IV did not provide a diagnosis of cannabis withdrawal; should DSM-V continue that position? (b) Should SUD be included or referenced among 'Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence'? (c) Can inter-rater reliability of the substance abuse (SA) criteria be improved with altered example situations, text descriptions or phrasing of the current criteria? (d) Between ages 14 and 18 years is earlier onset of SUD a severity marker that could be incorporated into DSM-V as a predictor of worse course? (e) In DSM-V could a phenotypic descriptor of pathological multi-substance involvement document severity and predict course of SUD? (Adolescents and substance-related disorders: research agenda to guide decisions on Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)
Author(s): Crowley TJ (Crowley, Thomas J.)
I think Thomas Crowley may have been previosly involved in the generation of DSM-IV...
What more issues not yet resolved...Abstract: Aims Over the past two decades, many nosological issues have been addressed by the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) substance use disorders workgroups. Even with those efforts, there are key issues that have not been resolved and must be revisited, or addressed de novo, by the workgroups. These lingering points are broad, due to the array of substances classified under the diagnostic umbrella of substance use disorders. They include substantive issues ranging from dimensional approaches, similar criteria for each substance, cut-points and thresholds, distinct abuse and dependence classifications, new criteria and drugs, to less substantive ones, such as the adjectives used to describe the severity of the behaviors.from article ;Characteristics of nosologically informative data sets that address key diagnostic issues facing the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) and International Classification of Diseases, eleventh edition (ICD-II) substance use disorders workgroups cited from Cottler LB (Cottler, Linda B.), Grant BF (Grant, Bridget F.)

Now I am not personally saying this (below)article is true or not, So don't jump down my neck... I have included it as it appears to me to be an issue for debate... Is it worth refuting? Or is it too low brow for you???
Listening to Prozac
How do new disorders get into the DSM?
By Annie Murphy Paul
Posted Tuesday, May 2, 2006, at 3:37 PM ET
More than half the experts who compile the Diagnostic and Statistical Manual of Mental Disorders have ties to the pharmaceutical industry, according to a study published last month in the journal Psychotherapy and Psychosomatics. Produced by the American Psychiatric Association, the DSM is the guidebook used by mental-health professionals to diagnose mental illness. Fifty-six percent of its contributors have received research funding, speaking or consulting fees, or other forms of financial compensation from drug companies, the recent study reported (though the authors did not determine whether these relationships existed before, during, or after the experts worked on the manual).



Would the above notions indicate .......issues, contention...?? Who am I to say??? Just a lowly crap spouter....

When will 5th ed. be published...projected for 2010/11...ish....

 

[Dancing David]

My comments were not intended as a personal insult to you ...Dancing David but to incite discourse and debate in the ethos of 'JREF' to discuss skeptism,critical thinking, the paranormal and science in a friendly and lively way!
I have given a few reasons for my comments regarding the DSM, below but as I am in your opinion not capable of spouting anything but crap, I dare not proffer to you an opinion...just give you research based information..

sorry, my mistake, you are better than most who slam psychiatry and mental health. You have cited some sources, some of whom I have read and seen in person.

"We have already noted that the political wisdom concerning scientific processes—peer review, informational and critical openness, accountability, citizen involvement, and due process—results in better science. More specifically, patient and family involvement could contribute to greater face validity of categories, not just for clinicians but for patients as well. Patient and family collaboration could improve face validity by addressing stigmatizing language, clarifying the thresholds and boundaries of illness, and identifying the appropriate balance between personal resources and disorder deficits in the consideration of classifications. " That would unfortunately for you include crap spouters like me....??? please follow this link if you would like more information on this; http://psychservices.psychiatryonline.org/cgi/content/full/55/2/133#SEC3Health Care Reform Based on an Empowerment Model of Recovery by People With Psychiatric Disabilities; Daniel B. Fisher M.D., Ph.D. An article suggesting
empowerment for your clients??

" in the dark depths of our so termed 'progressive' civilisation our most neglected truth is that sufferers of mental illness are swiftly deposited by society into the hands of medical practitioners whom themselves may have not updated their own perspectives" is what you said. Not what Fisher said at all. Where is the data? When was that published. What is the prevalence in current practice?

So you condemn all of mental health and psychiatry. I resent that, I was into empowerment as was every person I worked with, then I had to sit through condesending lecture by 'consumers' who don't want to be empowered they wanted excuses, I had to sit in a lecture by opur director (the most backwards and repressive in her thoughts) about how we had to embrace recovery all because she wished she was a doctor and wanted to dictate to the psychiatrist.

The recovery movement is very important, but it reached extreme hights, especialy with the 'consumer' thing and all the bogus language. I already held people accountable, I already treated my clients as humans, i already did everything that the recovery movement wanted.

SDid they aknowledge that it was already best practice? No, they didn't. Did they aknowledge all the people whow ere already doing it as a best practuice. No. Then I was sexualy harrased by a lady who yelled at the clients, took our PSR program from 60 to 8 clients because of her behavior, and she was our recovery advocate.

I agree with Nicolette larson who works for DMH as a recovery advocate, she says treat people like people, expect them to be capable and able. Help when they ask for it and need it. Treat all people as people , with respect and dignity.

I am sick of people blaming the mental health movement for stuff that they weren't doing. I was already doing best practice, as were the twenty people on the case management taem. But then I had to suffer a bunch of stuff from people who didn't know any better.

At my last job I had to quit because of the continual ethical violations and limitring of client rights. It was in a small county and town of about 60,000. But that does not mean that is the mainstream view. It is a problem but it is not a system wide problem.
As noted in a prior post i cited both Feese and Fisher, I have also been at a conference held by Fischer and Feese. I prefer Freese.

The stigmatizng laguage is a best practise issue. I have no beef with that. But to condemn the whole of psychiatry is another issue.

I also disagree with Fisher that people should be allowed to just live in an institution if they choose to do so. I can't say that ICFMI (intermediate care facilities for the mentaly ill) are that great a place. I had clients who dealt with that issue. It is not helpful to allow clients to self stigmatize either. But one can only approach that issue with compassion and gentleness.

I apologise for accusing you of crap spouting.

You condemned a wide sector of mental health with no qualifiers at all.

Now why research an infallible reference....what...contention.....oh..its a classification issue...who can advise?? perhaps...Robert L. Spitzer, M.D., Chief of Psychiatric Research Janet B.W. Williams, D.S.W., Deputy Chief and Research Scientist VI
Michael B. First, M.D., Psychiatrist: (Research) I
Miriam Gibbon, M.S.W., Research Scientist IV who state specifically;

"Problems with the current DSM-IV categorical (present vs. absent) approach to the classification of personality disorders have long been recognized by clinicians and researchers.

Ah well, the persdonality disorders!

The first problem is that it states very clearly in the DSM that thou shall not diagnose a personality disorder if it is co-occurent with an active symptom of AXIS I, and what do doctors do, they diagnose a suicidal individual with active PTSD as Borderlione PD.

So they don't even follow the instructions.

I was trained that they should be reffered to as "unhealthy patterns of interaction and coping skills" and that they should be reffered to as tendancies in assesments and not assesed at all.

These include marked comorbidity among the personality disorders, arbitrary distinction between normal personality, personality traits and personality disorder; and limited coverage (the most commonly diagnosed personality disorder is the residual diagnosis of personality disorder not otherwise specified). "

As stated often people are not following the directions, if iou have an active axis I than no axis II PD.

I agree that it should not be an actual axis at all.

Please if you can just read this short article
http://wings.buffalo.edu/smbs/acb/neuro/lectures/DSMIVa.pdf

the dementia diagnosis criteria in the American Psychiatric Association’s DSM-IVTR (4th ed, text revision, 2000) have been compared with the World Health Organization’s International Classification of Diseases (10th revision, 1992). Critiques are based primarily on (a) internal consistency and validity of the classification, (b) historical development of the field, (c) conclusions of consensus conferences, and (d) current knowledge and practice. It is suggested that (1) the entire category be labeled "cognitive disorders," to better characterize this group of disorders, (2) there is no longer any scientific basis for the presenile versus senile dementia dichotomy at age 65, (3) Alzheimer’s disease no longer should have unique status as a "diagnosis of exclusion," (4) future manuals should incorporate knowledge regarding the clinical manifestation and course of Alzheimer’s disease and other dementias, and (5) the classification "Pick’s disease" should be broadened to "frontotemporal dementias." DSM-V should incorporate continuing advances in the neuroscience knowledge base and understanding of these disorders. (J Geriatr Psychiatry Neurol 2006;19:137-146
why suggest this????

that is not the same as reffering to the whole DSM-V as 'highly contentious'. I used the term crap, you use hyperbole.

Flanagan, EH, Author, Reprint Author Flanagan Elizabeth H. Flanagan, Elizabeth H. , Davidson, L, et al.
Issues for DSM-V: Incorporating patients' subjective experiences
AM J PSYCHIAT 164 (3): 391-392 MAR 2007
and....
Fawcett, J, Author Fawcett Jan Fawcett, Jan
Personality disorders: A case in point for DSM-V - Categories versus dimensions
PSYCHIAT ANN 37 (2): 78-78 FEB 2007

You might enjoy this one....
Bracha, HS, Author, Reprint Author Bracha H. Stefan Bracha, H. Stefan , Bienvenu, OJ, et al.
Testing the Paleolithic-human-warfare hypothesis of blood-injection phobia in the Baltimore ECA follow-up study - Towards a more etiologically-based conceptualization for DSM-V
J AFFECT DISORDERS 97 (1-3): 1-4 JAN 2007

and this
First, MB, Author, Reprint Author First Michael B. First, Michael B. , Zimmerman, M, et al.
Including laboratory tests in DSM-V diagnostic criteria
AM J PSYCHIAT 163 (12): 2041-2042 DEC 2006

all available at; http://portal.isiknowledge.com/portal.cgi

if you deem it worth your while..

a taste.....
.....common assumptions about what counts as an adequate category of psychiatric disorder. These dimensions are 1) causalism-descriptivism, 2) essentialism-nominalism, 3) objectivism-evaluativism, 4) internalism-externalism, 5) entities-agents, and 6) categories-continua. Four different versions of the medical model are described and compared with respect to these dimensions. The medical models vary in several ways, but all can be considered "essentialistic." As a counter to the essentialist homogeneity among the medical models, two nominalist analyses of psychiatric classification are reviewed. In order to fill out the space defined by the conceptual dimensions, two alternatives to medical model approaches are also described. After making some suggestions about where DSM-V might best be aligned with respect to the conceptual dimensions, the authors review the distinction between empirical and nonempirical aspects of classification—and argue that nonempirical aspects of classification are legitimate and necessary. cited from; Psychiatric Disorders: A Conceptual Taxonomy by Peter Zachar, Ph.D. and Kenneth S. Kendler, M.D

Have you read the preface to the DSM-IVR? I agree that we can always refine the way the decriptive model of communication is used.(And that is all the DSM is.) A multi-axial system would be much better if there were sub-spectrums. I firts enounterd the 'pyramif' in 1992 one corner is psychosis, another is depression, another mania and another anxiety. Most people vcan be categorised inside the pyramid and it could be amodified in extra dimensions for all sorts of things.

I agree that statistical evaluation of all diagnosis, presenting symptoms and effective treatment would be useful.


there is always room for improvement.

"'highly contentious"?

Thankfully, there are individuals who not only raise issues but suggest solutions, such as;
Beyond Clinical Utility: Broadening the DSM-V Research Appendix to Include Alternative Diagnostic Constructs
Michael B. First, M.D.
Over the past 15 years, researchers have argued that DSM-IV criteria are hindering investigation into the etiology, pathophysiology, and genetics of mental disorders (1–3) and have proposed changes to DSM-V to make it more useful for research. These include moving from a categorical to a dimensional approach more friendly to research (4–14) and adopting a "genetic nosology" that seeks to classify patients into categories that correspond to distinct genetic entities (15). However, because DSM must serve many masters (16), the prospect of including diagnostic constructs useful for researchers but unfamiliar, burdensome, or of unknown utility to clinicians creates a dilemma: how can DSM-V maintain its role as a common diagnostic language facilitating research efforts without seriously compromising its clinical utility?

Considering that there are 300+ neurotransmitters there are most likely three hundred different scizophrenia. The DSM is a descriptive model at best, so such modification will be proposed and adopted over time. Hopefully the whole thing will be scrapped in three hundred years.

'highly contentious"?
[/quote]


DSM-V's 'Substance Related Disorders' section: (a) DSM-IV did not provide a diagnosis of cannabis withdrawal; should DSM-V continue that position? (b) Should SUD be included or referenced among 'Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence'? (c) Can inter-rater reliability of the substance abuse (SA) criteria be improved with altered example situations, text descriptions or phrasing of the current criteria? (d) Between ages 14 and 18 years is earlier onset of SUD a severity marker that could be incorporated into DSM-V as a predictor of worse course? (e) In DSM-V could a phenotypic descriptor of pathological multi-substance involvement document severity and predict course of SUD? (Adolescents and substance-related disorders: research agenda to guide decisions on Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)
Author(s): Crowley TJ (Crowley, Thomas J.)
I think Thomas Crowley may have been previosly involved in the generation of DSM-IV...
What more issues not yet resolved...Abstract: Aims Over the past two decades, many nosological issues have been addressed by the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) substance use disorders workgroups. Even with those efforts, there are key issues that have not been resolved and must be revisited, or addressed de novo, by the workgroups. These lingering points are broad, due to the array of substances classified under the diagnostic umbrella of substance use disorders. They include substantive issues ranging from dimensional approaches, similar criteria for each substance, cut-points and thresholds, distinct abuse and dependence classifications, new criteria and drugs, to less substantive ones, such as the adjectives used to describe the severity of the behaviors.from article ;Characteristics of nosologically informative data sets that address key diagnostic issues facing the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) and International Classification of Diseases, eleventh edition (ICD-II) substance use disorders workgroups cited from Cottler LB (Cottler, Linda B.), Grant BF (Grant, Bridget F.)
[/quote]
This is the process of the DSM, "highly contentious"?

Now I am not personally saying this (below)article is true or not, So don't jump down my neck... I have included it as it appears to me to be an issue for debate... Is it worth refuting? Or is it too low brow for you???
Listening to Prozac
How do new disorders get into the DSM?
By Annie Murphy Paul
Posted Tuesday, May 2, 2006, at 3:37 PM ET
More than half the experts who compile the Diagnostic and Statistical Manual of Mental Disorders have ties to the pharmaceutical industry, according to a study published last month in the journal Psychotherapy and Psychosomatics. Produced by the American Psychiatric Association, the DSM is the guidebook used by mental-health professionals to diagnose mental illness. Fifty-six percent of its contributors have received research funding, speaking or consulting fees, or other forms of financial compensation from drug companies, the recent study reported (though the authors did not determine whether these relationships existed before, during, or after the experts worked on the manual).

I have only heard summaries of Talking to Prozac and the collusion of the pharmaceuticals is an issue.

However many people say that the treatnmment of depression is not effective with the ADs because they use the Beck depression Inventory, which is useful for assesment or severe depression and suicidal tendancies. However it is not good for examining response to treatment. A quality of life survey would be more accurate in my impression, and a better indicator of areas to improve functions and integration.
[/quote]



Would the above notions indicate .......issues, contention...?? Who am I to say??? Just a lowly crap spouter....

I apologise, again, I have before I will again.

When will 5th ed. be published...projected for 2010/11...ish....[/QUOTE]

More later, I have to go to the dentention room. Bad me, bad me!
I have finished it yay!

Originally Posted by freudianlip
I hear that and second it! Unfortunately, in the dark depths of our so termed 'progressive' civilisation our most neglected truth is that sufferers of mental illness are swiftly deposited by society into the hands of medical practitioners whom themselves may have not updated their own perspectives.
Still ...the psychiatric /psychological community are in constant debate regarding their own bible (as it were) the highly contentious DSM-V!

 

[freudianlip]

I do really appreciate your taking the time to read my hyperbole ( I accept your "So you condemn all of mental health and psychiatry. I resent that, I was into empowerment as was every person I worked with, then I had to sit through condesending lecture by 'consumers' who don't want to be empowered they wanted excuses, I had to sit in a lecture by opur director (the most backwards and repressive in her thoughts) about how we had to embrace recovery all because she wished she was a doctor and wanted to dictate to the psychiatrist." you are quite correct I made an erroneous assumption ,a sweeping generalistion and I might have deserved a good kick in the " projective identification"... In future I will insert a qualifier such as; some, those who..etc. (evil chuckle...)
also, in my experience working with ' learning difficulty, head trauma, varying levels of endogenous cognitive impairment and multifarious mental health areas where actually the subject of client " empowerment" easily became a vessel for unsatisfied projections from familial issues with, govt. bodies, relevant institutions, professionals and or what they perceived as "responsible for all of their failings" whether that be rooted in deeper personal issues or genuine lack of empathy from authorative figures. I agree totally the irony of others jumping on the 'client advocacy' band wagon is difficult and demotes an essentially well meant idea!
I will be delighted to respond to the rest of your erudite formulations with more spouting (lol) but unfortunately I must get busy in the nicest sense of the words...Please exscuse...

 

[Dancing David]

Have fun, or did I hope!

The biggest struggle I had was that family members wanted to protect thier mentaly ill family members from the consequences of poor choices. It is hard, but people learn best from natural consequences. especialy when family members would encourage the person to go off ther meds and get drunk and high and then call me screaming to do something. Second best is when a family member would encourage a client to move out of thier domicile so they could use the rent to get high and then call and say i HAD to find them housing.

Now there are mental health practioners and parts of the system (more collateral than formal mental health ) where adults are treated like scary children that might blow up at any time.

I am sorry for being over the top. I was worked up over the Cho thread in Politics and very disturbed at the time.

 

[freudianlip]

"Did they aknowledge that it was already best practice? No, they didn't. Did they aknowledge all the people whow ere already doing it as a best practuice. No. Then I was sexualy harrased by a lady who yelled at the clients, took our PSR program from 60 to 8 clients because of her behavior, and she was our recovery advocate"

Nomenclature error.......I can earnestly assure you that was No lady!!

"I agree with Nicolette larson who works for DMH as a recovery advocate, she says treat people like people, expect them to be capable and able. Help when they ask for it and need it. Treat all people as people , with respect and dignity."

Inclusive of practitioners...especially from their line management!

"I am sick of people blaming the mental health movement for stuff that they weren't doing. I was already doing best practice, as were the twenty people on the case management taem. But then I had to suffer a bunch of stuff from people who didn't know any better."

Also, suffering the projections and projective identification of family,friends for their own percieved failures!

I propose that the parameters of 'best practice' are continously evolving according to their cultural situatedness within a given society, here in the micro sphere of Ireland many opposite and some complimentary notions of best practice have dynamically changed it is hard to keep up....
from ,i will use the generic of "cognitively challenged" (CC), C.C. individuals being utilized in a productive way according to concurrent societal and professional perspectives...i.e. black bag packing, assembly line operations etc. to job coaching as it stands now inclusive of the perspective of society being the disabled party as it uses deliberate physical and emotional barriers to exclude the C.C. individual thus denying a truely multi cultural and enriched dynamic society. I have worked in some of these areas and found that disability included more referential points than those of C.C. or mental illness, ethnic minoritys, less educated, single parents all felt they were socio-economically or societly excluded and deserving of 'facilitatory' treatment.

"At my last job I had to quit because of the continual ethical violations and limitring of client rights. It was in a small county and town of about 60,000. But that does not mean that is the mainstream view. It is a problem but it is not a system wide problem.
As noted in a prior post i cited both Feese and Fisher, I have also been at a conference held by Fischer and Feese. I prefer Freese"


I am having some difficulty locating this author, could you please send me a reference. I have read Fisher and feel that there is too much emphasis on the 'recovered' individual...it is possible to live productively with mental illness.
I too have had hurrendous experiences working in both institutional and community-residential situations...Tieing up clients, deliberate over medication, hitting and punching 'back' at clients, etc...
These criminal actions I witnessed in the UK and duly reported them according to procedure, as they were perpetrated via nepotistic staff and or untrained,care-staff, even the police and BPS did not feel it was a situation warranting any attention. This was Summer work, while I was getting my BA in Psy. so they knew I could not stir up too much as I had to return to Rep. of Ireland each Sept. Though it was some years ago, in my youth I have always felt disheartened regarding the wall constructed from lack of empathy and 'not in my backyard' syndromes!

"I also disagree with Fisher that people should be allowed to just live in an institution if they choose to do so. I can't say that ICFMI (intermediate care facilities for the mentaly ill) are that great a place. I had clients who dealt with that issue. It is not helpful to allow clients to self stigmatize either. But one can only approach that issue with compassion and gentleness"

If you wished to join a hippy commune..scientologists..follow a guru....you could just up and go. You have choice...to make life and living an essentially personal and self related existence.Perhaps if 'institution' was modified to a more independently encouraging environment individuals would be less inclined to suffer from institutionalisation type ideologies. And more likely to engage with community life.

Ps. My version of fun is meself and the old boy( colloquialism for husband in Cork), supping coffee munching on ciabattas, yapping (spouting...)watching the yachts come out of dry dock in Crosshaven, a stunning estuary,five minutes drive from our gaff (house).
Have a great weekend, get away from this infernal, but engaging data entry machine, and consider the potential merits of hippy communes versus a cult habitation. LOL....
"

 

[Dancing David]

Hi, I already have problems with speeling and now my memory goes as well.

It is Fred Frese at Case Western University

http://www.fredfrese.com/

Wow, sounds pretty, not that the flatest part of Illinois in beautiful in it's own subtle way. When I need to get away there are a few rivers to sit by.

(Or I can fly to Oregon)

 

[freudianlip]

Fantastic proposals proffered by Fred Frese. Much more concise and pertinent regarding the role of the client and more especially of the practitioner. In my opinion such action would enhance mental health care globally and to see it in action would disperse perceived negative aspects of mental health practitioners. What about some sort of mental health review for psychiatric employees as I have witnessed psych. nurses mimicking patients mannerisms and behaviours both in and out of the workplace. Also to circumvent inappropriate goading of patients to "kick off" for the adrenalin thrill associated with more violent behaviours?

P.S.
Well, Ireland is lovely but having experienced British Columbia, we have decided to emmigrate this year..it has everything Ireland has but a more spectacular version! I have not yet been to Illinois but the ocean is my thing for R&R, rivers are gorgeous but here is something about the sea that disperses any negative ions for me.... Roll on Summer..!!!

 

[Dancing David]

Fantastic proposals proffered by Fred Frese. Much more concise and pertinent regarding the role of the client and more especially of the practitioner. In my opinion such action would enhance mental health care globally and to see it in action would disperse perceived negative aspects of mental health practitioners. What about some sort of mental health review for psychiatric employees as I have witnessed psych. nurses mimicking patients mannerisms and behaviours both in and out of the workplace. Also to circumvent inappropriate goading of patients to "kick off" for the adrenalin thrill associated with more violent behaviours?

P.S.
Well, Ireland is lovely but having experienced British Columbia, we have decided to emmigrate this year..it has everything Ireland has but a more spectacular version! I have not yet been to Illinois but the ocean is my thing for R&R, rivers are gorgeous but here is something about the sea that disperses any negative ions for me.... Roll on Summer..!!!

I love the ocean, I just ended up here. The goal is to move to Newport, OR once my son graduates from high school (secondary). I grew up in LA before it was scary and lived two blocks from the beach.

 

[freudianlip]

My husbands brother lives in LA, Northridge area ,but one of his sons moved to a huge apartment complex in Malibu. its nice but very face (sorry... freudian slip...lol....)fast paced there. Its amazing to me as well (living in Ireland) the size of these complexes and the status accorded, everyone is within a certain age range, earning a certain income level, single, enjoys similar leisure pursuits,attends the gym for x amount of time, there must be a doctorate there for some one who would deem it worth while. Ahhh...so you will retire to the sea..... That is a wonderful idea. Even in Winter the sea is spectacular...especially during storms! i find it hard to vacation anywhere but beach front properties, except of course Fairmont Chateaux lake Louise...B.C.....Opening the curtains there is the most surreal, breathtaking experience I have had in my whole life! And thats inclusive of birthing 2 lovely boys. Highly recommended for a romantic 'filthy','dirty' weekend as we say here. Perfect place to earn 'yerself some romantic brownie points...lol

 

[freudianlip]

Has anyone else noticed mental health staff mimicking or stimulating certain behaviours of "institutionalised" patients?

 

[freudianlip]

 

[freudianlip]

 

[Dancing David]

Has anyone else noticed mental health staff mimicking or stimulating certain behaviours of "institutionalised" patients?

They do , but they shouldn't, I can't do impressions anyhow.
I used to tell stories, but I don't break confidentiality.

 

[freudianlip]

I have been told stories without disclosing client confidentiality too, but i see that as a form of release, especially when in the company of friends in related areas.However I have noticed some para and nursing professionals bring mannerisms and mimic Tourette type outbursts for entertainment among friends.Do you think that there is some sort of disorder which would explain such irrational behaviour? Would you know of any current studies on this topic

 

[freudianlip]

I must unavoidably leave this thread for a few days...humble apologies.Please continue