Eclecticism vs Specialization
In this TedTalks a scientist discusses specialization and its counterintuitive limitations.
Eclecticism: An emerging specialty that changes how modern day mental health services are converted to the best interest of the client.
By Kurt LaRose
MSW LCSW CHT CSW Supervisor and LICSW
As illnesses are a criteria for a number of reasons in talk therapy – specialties in talk therapy are too. A number of differing professionals, with differing credentials and all kinds of certifications and targeted training can make the whole thing of looking at who to work with a bit overwhelming for clients who are seeking care. Too specialization can lead many professionals to question their own competence – not because they necessarily are incompetent but because they have not joined a specialty band wagon. In my summary of eclectic mental healthcare, I would say that similar to an MD who is a “primary care” a talk therapist who is eclectic could be seen as a generalist. Does a generalist not have an expertise?
Foods, exercise, beliefs, cognition, how the brain and the mind work, the science of happiness and the frameworks for illness – all impact energy, sleep, mood, focus, motivation and connection to others. How people feel, think and act is affected by more extreme variables too – past histories of violence, safety situations, mental illness, disease – and major life transitions. The environment is a factor in what alters a person’s life – which can be negative, positive – and/or both. People are quite unique – fingerprints, DNA, epi-genes, retinas – these make what will help one person potentially not a fit for another.
A clinical social worker would likely view you from a person in the environment perspective – as one way to interpret and understand interactions that both decrease and increase desired life progressions, trajectories and changes. Much of mental health service deliverables emphasize damage, harm, hurt and causation to explain dysfunction with a focus on diagnosis, illness and a medical model paradigm. Increasingly, and this is not new to mental health, practitioners are grouped together not only by training and certifications, where specialists abound within disciplines. Some specialists work with only one population as the area of expertise is honed – both in training and in practice experience.
Virginia Satir (in The Satir Model) looked at the differences between a medical model paradigm (a hierarchical system as she described it along with other top down examples) and the consensus building model (where enlistment and equal regard operate to move forward – together). While Satir’s life ended in 1988, and while her book has been re-published a number of times since it was first written, her impact in the trajectory of mental health delivery is a part of what makes an article about specialization easier to justify.
Dennis Saleeby a number of years later (early to mid 2000 I think) highlighted the strengths based view in his work called The Strengths Perspective in Social Work Practice. Saleeby fostered a view that compared and contrasted an illness paradigm to one I’ll label here as a resource driven paradigm. Saleeby did not say that illness was irrelevant, however he suggested that illness did not take away strength and ability. People then, that is you, are useful in moving themselves along with the strengths they already have (or that they can find) even if/when they are ill.
Satir and Saleeby are not new in the language and literature of social services care – and it is not unique in social work for an “out of the box” view to appear – going back to the profession’s earliest days. But the ideas of consensus in client and provider interactions along with a strengths based view to overcome what ails, to this day remain a bit of a challenge in helping people who are deemed “sick.”
Dr. Nic Hall during a presentation in February of 2012 (in Food for Thought and the Institute of Brain Potential) discussed overlapping symptoms of mental illness conditions as being possibly grouped in such a way to be more like syndromes. That is, in his way of discussing the concept of syndromes in mental illness, indicators may exist collectively without meeting a DSM (diagnostic criteria) exactly, yet evidence is sufficient to warrant interventions. Going further, it’s conceivable, again in the context of syndromes, that categories of mental illness may be akin to something going on that could be an illness – but instead were rooted in the intake of certain foods and sleep deprivation (together or even separately) as the culprits of correlation or cause. Dr. Hall discussed diagnostic indicators that are evident and not exactly attributable to illness by specimens of blood or urine or any form of physical examination (including scans of the brain for example) as factors also correlated to stress. Here, the point is, that intake factors, sleep factors and stress too may be some of the suspects for what clients and providers call – mental illness. Even when mental illness is unequivocally clear by some evidence, expertise and clinical evaluation – food, sleep, stress and exercise are not irrelevant to effective care.
There are problems however with the diagnostics process in mental illness. Dr. Joel Paris, a psychiatrist (an MD in mental illness) who was once an active stakeholder in developing the diagnostic criteria for mental illness in the US wrote about bias in his 2013 text The Intelligent Clinician’s Guide to the DSM5. He questioned if the diagnostic criteria for mental illness had not progressed to a point of medicalizing normal. The point here is that bias is a player in mental illness diagnosis and therefore a player in its treatment. And Dr. Paris is not alone in the questioning of diagnostics.
Could mental illness, or at least most of what is called mental illness be a factor of traumatic events?
In my work in PTSD there are so many ways that it is misdiagnosed (thought disorders, anxiety, depression, bipolar and even addictions), such that as the PTSD symptoms are improved the other disorder symptoms usually (not always) resolve simultaneously. That is to say that while clients can have co-occurring or co-morbid disorders, I have found more often than not when the PTSD is cleared up the other overlapping symptoms do as well. Even addictions are, in my work, increasingly appearing to be self medication efforts at trauma, as opposed to being independent addictions.
As two examples here are a couple videos to consider. First is one that looks at how loss (in this video by CBS’s YouTube Channel) could be a player in depression (and how it is that the death of a loved one – which we will all experience in life – is traumatic):
Next, a Ted Talks speaker discusses a couple of studies that look at addiction through a lens of what I’ll call the life satisfaction model – rather than it being a disease. Here the speaker is bold enough to say that “everything you think you know about addiction is wrong…”
A number of years ago a psychiatrist wrote an opinion piece in the New York Times basically saying that life is traumatic. Here is more what Dr. Epstien said in 2013:
Trauma is not just the result of major disasters. It does not happen to only some people. An undercurrent of trauma runs through ordinary life, shot through as it is with the poignancy of impermanence. I like to say that if we are not suffering from post-traumatic stress disorder, we are suffering from pre-traumatic stress disorder. There is no way to be alive without being conscious of the potential for disaster. One way or another, death (and its cousins: old age, illness, accidents, separation and loss) hangs over all of us. Nobody is immune. Our world is unstable and unpredictable, and operates, to a great degree and despite incredible scientific advancement, outside our ability to control it. –Dr. Mark Epstein in New York Times
Epstein includes a list of life events that nearly everyone will experience in the course of living – including addictive family members and rehab. I cannot help but wonder if in the trajectory of life, if everyone experiences them – are the traumatic events and their effects also not a part of everyone’s experience? This is not to say that trauma is not a factor or a diagnosis – it is: it is to say that if everyone experiences something traumatic a general understanding of ages and stages and phases of life (and death) would require an eclectic view of mental health, mental illness, diagnosis, treatment and rule outs. The eclectic view would of course include environmental factors, genetics, physical and nutritional aspects, sleep, hormonal shifts, general life satisfaction.
Dr. Suzanne O’Sullivan in 2017, a neurologist, writes about how happiness is a neurological influence on psychosomatic illness as one of the implications of brain scans. She believes neurons misfire, in part, making the body ill literally, due to what could be seen an having “no cure for unhappiness.”
Eclectic mental health would need some basic knowledge of the study of happiness, growth after trauma, personality traits of thriving in the midst of survivalist circumstances, the impact of food, and fluids and even how drugs and medications effect the brain – with even a little knowledge in the workings of and in the changing of brain.
Diagnosis in Mental Health is “…scientifically meaningless…” and subjective
Besides the critique of Dr. Paris related to the impact of making normal – into sick – and Dr. Halls discussion about mental illnesses being more akin to syndromes, very recent information about the impact of subjectivity and bias in the mental health paradigms looks too at the flaws in diagnostics. That diagnostics are “scientifically meaningless” comes from researchers based upon their findings released as recently as July 8, 2019. According to the folks who reference the study at Neuroscience News the lead researcher says this:
“Although diagnostic labels create the illusion of an explanation they are scientifically meaningless and can create stigma and prejudice. I hope these findings will encourage mental health professionals to think beyond diagnoses and consider other explanations of mental distress, such as trauma and other adverse life experiences.” Dr. Kate Allsop in Heterogeneity in psychiatric diagnostic classification
Another co-author and researcher of the same study was so bold as to call diagnosis un-critical, internally inconsistent, confused, contradictory – while also saying that the criteria appears to be based on a subjective view of normal. Dr. Kinderman stated that going about diagnosis as it is currently done is “not fit for purpose.” The same study was released announced on LinkedIn profiles and can also be seen as discussed by Medical Express.
The convergence concept of medical, biological, genetic, environmental and even stage theory approaches …
The idea that stage theory and diagnosis, along with considerations of environmental variables, trauma, stress, nutrition, exercise, sleep, brain function, genetics, cognition, variables of beliefs even – and specialization – are too complex to be summed up in one profession or one professional. Eclectic is to suggest a broad awareness of multiple disciplines, the differences between soft and hard science, studies that are evidenced based both in illness and in recovery, with an awareness that normal does happen (and in fact it is pretty common) and that prognosis with improved outcomes is key.
In 2019 John Arden brings a wealth of data from multiple experts to one text (where he wonderfully highlights and credits the contributors along the way) – tackling a collective view of many disciplines and perspectives that can be aligned with the hard sciences. Arden (and his cohort referenced) potentially has in Mind-Brain-Gene written the foundation text for future syllabi altering the training trajectory for seekers of improved mental healthcare in the US. More and more thought, neuroscience, genetics, hormones, diet and even the beliefs of both clients and providers is gaining ground in changing how mental health services work. No longer is it sufficient to interpret human behavior as healthy or sick only, in need of one specialty to achieve a cure or another, or to be interpreted by age-old theories – that are frameworks in explanations. What the hard sciences increasingly reveal, and what theories and models may have articulated and the lives that clients prefer – can be integrated to a better form of mental healthcare. In Arden’s book he discusses the changing face of mental health services in biology, belief and bias for what I would argue is the escalation for improved outcomes by professionals inclined to see more of clients, more of you, via the lens of overlapping sciences regarding the human via body, brain and environment.
As mental health practitioners are increasingly introduced to key biological aspects related to human functioning, particularly the brain, not only in its development and formation in illness, but also in its normal functioning throughout the life span – the field of expanding specialization may begin to shrink. Similar to what medicine went through, say a hundred years ago or so – talk therapies will transform as more science is introduced. And as the operating system of a person (you and your brain, as one example), is viewed through how it works and how it changes – less emphasis on will be placed on being broken with implied lifelong barriers to living.
Ultimately, frameworks for mental healthcare (particularly in talk therapies) will change too. As the field adjusts to a more exacting science, borrowing from other disciplines particularly, agreement in what is deemed more credible to see clients through to healing will create a convergence of care.
- | What about foods (and food changes) on mental health?
- | With so many different professionals – who should I see?
- | How would Couples Counseling work?
- | What if I’m in the LGBTQ community?
- | Isn’t Hypnosis a specialty?
- | What about stress – does that make me sick?
- | I have children. Isn’t mental health and children‘s therapy different?
- | I think a family member of mine is having difficulties with sex. I heard sex can be an addiction?
- | My family and I have been dealing with a person who Batters. Can a batterer be helped?
- | Anxiety disorders and depression – what do you think about treating these?
- | Doesn’t insurance require diagnosis to bill them? How can that affect my care?
- | I really do not want to see a person in an office. I want to begin with chats or video sessions – or do both – is that possible?
- | Clinical social work, isn’t that a specialty too?
- | What about medications in mental health, doesn’t that require and medical doctor?
- | Can you tell me about some specific mental health disorders?
- | What other stuff have your written about and where can I find it?
- | And references, do you have them too?
The hard sciences may help in moving from “why” to “how” for better outcomes in mental health….
Recently I was chatting with an MD of integrative medicine on LinkedIn where he asked me a question about where I see the most help in my community. My community of where I help is primarily that of my clients and my answer was in that regard. Similar to what I tell clients I told the MD that giving people information about how something works (in its dysfunction and in its improvement) seems to move things forward. It is easy to get hung up on why something happened, and this “why” thing seems to be key in getting unstuck. WHY is most helpful in prevention of something, where HOW is most helpful in intervention of something. I often say that mental health has looked at the “why” of things, which may only give explanation to it – when it is the interventions located in the how of things. How it works, for example in changes in both harm and in improvement. An example I use is that medical doctors once used “why” to justify non-treatment of patients or lack of progress as a reason for being “stuck.” If a client drank or smoked or broke the law or had tattoos the why of their conditions seemingly gave tolerance for them as self created. It was as if a moral concept was driving medicine. Then hard science increasingly showed that biology can be altered such that how to (how something happens and how it changes) is what effects curative outcomes (and if not curative, then improved ones).
Cause matters in understanding and in prevention of something in the future. Correlating this to that matters in finding what works for a set of presenting problems (assuming those problems are in the abnormal categories to establish illness).
Saying that smoking is why you have cancer is at some level harmful – particularly as the patient may know this or as the patient be hearing that they caused their illness (which is hardly the case; they may be addicted to nicotene, they may be in a culture that creates a view that is scientifically ill informed, they may have listed to tobacco executives say the science was false and they may have used cigarettes as a solution to severe stress). The point is when a patient is seeking care for an evident diagnosis telling them that the why is what they did – will not help – and in fact may harm. How cancer emerges and how it is treated based upon what is evident – this moves to improvement and correlations – and away from cause and away from why.
To prevent something in the future is where cause and why are key considerations. Looking ahead, knowing that smoking causes certain kinds of cancers could be useful in prevention of those cancers and reducing its occurrence. Here a discussion of why is helpful – because it applies to improvements in preempting illness.
The same can be said in mental health. As more and more neuro-biological information (along with genetics and along with nutritional variables, and yes the environmental ones too) are making their way into mental health (just as the hard sciences shifted medicine a century or two ago) the why as to a person being mentally ill is less and less relevant. Once the criteria for illness is established a fitting treatment is needed. And here, how brains are harmed is a consideration in diagnostics (and explanation maybe), with an increasing emphasis on how brains are changed in recovery. For generations the focus on why this and why that – not only in explanation but insidiously (that is almost unbeknownst) could serve to enable and in some ways creating collusion for long term care. When the why conversation lingers for too long, with the revisiting of why a symptom is over and over pointed to – a slower progression in care can be expected (for clients and providers).
The corresponding treatment to an illness is what is needed, particularly I would argue in mental health – not what causes the illness. This is not to say history doesn’t matter because of course it does – in brevity, in occurrence, in course and in prognosis (that being what is an expected and reasonable outcome based on the diagnosis that is evident). Why questions intone a level of morality – who and what causes ones illness, for example, gives some credibility to who to blame. The why will lead to a blaming of self, a blaming of others – and here mental health can deteriorate – since blame will potentially produce decreased outcomes. A source of mental illness can help as a starting point – assuming that diagnosis alone is scientifically credible that is. Either way, from sources to how it (brain, body, thought, the environment, genetics, hormonal shifts, development, a collection of indicators as syndromes, trauma, and diagnosis) works and how it is improved (also using brain, body, thought, the environment …) will lead to a developing plan and prognosis.
So this use of a collection of information across and from differing sources helps most of my clients move from who and what causes the problem (the way of it) and instead helps them get to what can be done and what to do – to get better. Finding what can be changed (and what cannot be as well) is about the how. Causation (the why of things) is helpful in prevention where correlation (the how to move something to better) is what is most helpful in treatment.
Is this view, the idea that brain processes and recovery processes, aided by more and more hard sciences makes an eclectic approach a credible one. And of course the issue of bias is a factor too. A more critical view of the information clients provide in sessions will necessarily have to look at the impact of bias in care.
Primitive understandings of various treatment paradigms and models are strengths of clinical social workers. Looking at a person in the environment is a key aspect to the discipline as well. Adding to these paradigms and frameworks primitive understandings of the brain, nutrition, exercise, sleep, stress and the environment will aid in decreasing bias that perpetuates care when that is possible.
Brief treatment is not possible in certain disorders and a mental health provider can tell you more about that if and as a lifelong mental illness is evident (and here too, finding the right science that supports improved outcomes for lifelong ones).
A simple look at bias …
The idea that there are problems in diagnosis means too there are problems in treatment – and specialties based on non-scientific diagnostics may lead to bias driven (subjective) interventions.
Implicit bias is believed to be, by literature, research and blinding analysis (those are my biases in this regard) very difficult to change. And those “believed to be” words are apart of the story. It’s possible that in the study of bias we “prefer” knowing that we have “it” right. And therein lies the irony. HOW you think may not change (the hippocampus, prefrontal cortex, etc do what they do). WHAT you think (outside of safety) is optional. Bias is SIMPLY changeable.
Think about some of the words you use everyday. Think about how they direct you in all of your interactions with those around, in your work, in your families and in your judgments of self. Kurt LaRose LCSW, CHT, CSW SPRVSR and LICSW (TalkifUwant on Instagram)
I’ve tried a number of times to specialize. It’s a big big thing in medical professions and in mental health. As a clinical social worker – the profession where the clinician is trained in almost every form of intervention – such that we know a little bit about allot and that’s the one thing we know the most about – the PIE perspective is worth a read. Early in my work it is what I was most proud of – and enjoyed working in that framework. Later the specialization bug kicked in for me as an expert in youth, addictions, sexual behavior, then onto hypnosis, and next was online digital therapies, adding trauma – and even more as I expanded my work and licenses into two different states I began to promote specialization. In time, my clients demanded that I provide care that fit their requested solutions vs. my desired specialties.
Artificial Intelligence in Mental Health …
In time artificial intelligence may very well produce an advancement in mental health and mental illness findings making diagnostics, evaluation, assessment and treatment planning a more exacting work. The ability of memory storage and memory recall alone, combined with complex correlations and algorithms, suggests that it is no longer far fetched to consider that AI may very well change mental health diagnostics and treatment in radical and progressive ways. Imagine here, that with a Q and A that progressively changes in its uses by profession and by provider – where AI intuitively using intersecting data points, could move with people navigating through deductive and inductive reasoning. All of that, while calculating multiple variables within some short timeline telling provider and client what it is that only the human element CAN do (where AI limitations will almost certainly always remain). AI processes could conceivably conclude with a degree of certainty (and the human element remaining necessary too) rule outs, diagnostics and treatment options with a few clicks, check boxes, facial scans and verbal responses. AI could (if it is not already) compile data for bias similarities, language similarities, dialect similarities – and the list is non-exhaustive here – content and context collection, history collection, political collection, cultural relativity collection, cultural norms collection, gender collection, age and developmental collection, ethnicity and religiosity collection, formulations of status collections all so that large groups of “this” and “that” are scored. The scatter plots of the past could all be produced by person and provider – correlated to standards of health and sickness – with conclusions that are quite precise moving mental health and mental illness to an advanced level! Even intonations and other past qualitative variables could be detected and grouped, correlated and contrasted for a more scientific lens. Add too, AI’s retention and updating prospects, aspects of biology, food and sleep and stress as well as existing knowledge in genetic mapping content and even brain scan data what emerges is an interactive navigation of a persons life via AI for more accurate and bias free findings. It may sound a bit scary, but pick up your mobile device now, speak to it and then cuss at it; it may surprise you in what it “knows” simply based on data! With AI, the possibilities are exponential in mental health and mental illness treatment.
A quick look at a “clean” and “easy” way to eat healthy (garbage in and garbage out is not only about technology) …
A more thorough read of nutrition …
Specialization may be helpful and it may be prohibitive. Consumers of mental health, that is likely you and you’ve read this far, might first consider all of your options, seeing who does what BEFORE fully engaging in care. Consumers may even ask if a free consult is possible. You don’t buy cars without giving them a try first, so why not ask if a consult would be okay?
Clients may prefer a specialist – and if so, okay. Too, a specialist may be able to help resolve one thing, while needing to again refer you to another specialist. Providers may be really really good with an area of mastery however its possible a well sharpened approach will be applied to a broad area of work. Biases are likely traceable in this regard, at least in what clients seek in what providers treat.
If applicable reviews used with written consent for marketing purposes and without compensation.
What I’ve learned over time, and I’ve learned this every single time I’ve moved toward specialization – is the direction of specialization is inadvertently about my biases’ not necessarily my expertise. Specialization may limit my ability to effectively help the client sitting before me as I may attempt to direct them to what I have as opposed to the client directing me – to what they need. You see, my clients showed me that a specialty might not fit their case, particularly as the case gets increasingly unpacked over time. They would see my promoted specialty, assume that they fit, and then as we worked together trying to make it fit, many times the client would not progress. Why? Bias – not only mine, but theirs too. Frankly, the studies on implicit bias are not too promising in moving people out of their own … however science has a really cool way of shaping things and as such I am not back to my earlier training concepts – I am not a specialist at all anymore – I am a real social scientist using real science to shape all of my work.
Years ago, in 2011 on a blog in Merchant Circle (and my business facebook page, later to my Instagram, and my google business site too!), I first wrote about people being unique and lumping them into categories as a scientific flaw really — and it summarizes sooo much, why eclectic work is critical to helping:
In statistics when an extreme outcome is realized, it is often lumped into an “outlier” category, so as not to inexplicably alter the norm. The problem is that every person is quite unique, and not all outcomes can be standardized within a limited number of deviations. “Normal” is great – but so is the magic or the miraculous or the unexplained….people change, and many times against all kinds of odds — just because it looks like or sounds like an outlier – doesn’t make it un-true, false, or abnormal. It might just be wonderful! www.TalkifUwant.com Posted September 21, 2011 at 07:53 AM
Do the words we use matter?
Language is a key in not only communication but also in thought. For thought to be shared some form of language applies – either in interpretation of action or in the expression about action. Mentally thoughts emerge from language where every letter and word combined creates perspective. Intellect is the ability to see a future and a past something that distinguishes humans from most animals. So for intellect to operate, language being stored in a memory center, how the language is created can itself direct thinking, direct perspective. Trauma affects language (what is expressed in communication) just as much as happiness and love do as well (these too will direct perspectives articulate through words of some form or another). For words to change, beliefs must be considered in their formation. Linguistics are a part of all explanation and in helping people change perspectives, at conscious and less than conscious levels words are key construct in hypnotherapy. And it is one area where I specialize, in part because the practice is regulated in some jurisdictions – and in part because clients increasingly are interested in this method if/when other options are seen as less desirable. The point here is that the lexicon, the language that all people use, providers and clients included, can impact how care is implemented and received. Just as people are impacted and affected by many variables in life, creating perspective, eclectic mental health applications may be equally necessary.
Medications, Hospitalizations, Safety and Specialties of Higher Levels of Care …
I’m not saying specialization is not needed – it is. Often clients (and providers too) think they are very sick or messed up, when really just a bit of a tweak in a perspective is needed or maybe just a bit of education that looks at how brain, mind, body, nutrition, sleep and exercise work too. This is true for a person in talk therapy and for a person who is taking medications. In fact, in many scenarios the medication assisted treatment model is gaining more and more evidence for complex and/or hard to treat mental illness diagnoses’ and improved prognosis (substance use disorders, anxiety disorders, depression – and others – for example). Even this little bit of information can aid clients in improved lives.
Safety changes everything and in mental health services delivery safety risks necessitate specialty care where lack of progress is evident and/or harm is evident. Referring clients to others in a lack of progress situation (or going to see a different provider due to slow and non-progress) all makes sense. This would be even more true if and after a clinical psychologist does psychometric testing (emphasis added on psychometric testing). At times medications and hospitalizations are needed, and in psychiatric mental healthcare (talk therapy experts must refer). Learn more here about other professionals in the mental health business…
So for me? In talk therapy – non-specialization is my specialty. I’m eclectic.
What a talk therapist really needs, in my (ironic as it is to say) biased view, is not a specialty as the focus or the one area of certification and continuing education and repetitive credentialing (licensing standards assure minimum mental health qualifications are already met). Why? What ONE client presents with ONE set of things needing ONE form of care? Too if you are a client seeking mental health services, an eclectic provider may be able to sort out quickly what is in need of specialty care and what is not. As I mentioned earlier, similar to what might happen if you check in with a primary care doctor or generalist wondering if “this or that” needs more attention.
You are unique. You know your life better than anyone. From fingerprints, to retinas, to DNA – one version, one size, one of anything cannot help everyone. Here’s how I’ve written about “help” – as a definition ….
To be what google definitions (and others on the web) calls “comprehensive” and eclectic (as eclectic is itself defined) and in my view to be an effective social scientist some basic training in key areas are needed along with a varied reference source for the pros and cons of – well – frankly everything! This list is not exhaustive (and more links are coming soon), it is more of a biography or sorts (as opposed to more formal referencing)…as a high degree of credit and thanks can be attributed to many from and within many areas of expertise:
- diagnostics as flawed, subjective and non-scientific – as a matter of research is somewhat cutting edge comes from researchers based upon their findings released as recently as July 8, 2019. According to the folks who reference the study at Neuroscience News.
- a primitive understanding of areas of the brain involved in thinking and in feeling and how it is that thoughts are created and where they therefore originate (Dr. Atkinson and Emotional IQ).
- a basic understanding of hormonal processes and influences in the body – from birth to senescence (thank you FSU College of Social Work), as well as the variations of hormones in times of varying forms of stress (illness, work, relationship, mental health, trauma, addictions, etc)
- a working knowledge about chemical and psychological equivalence – such as testosterone as confidence and cortisol as doubt (thank you Dr. Cuddy), dopamine as motivation (Dr. Hall and Dr. King) and oxytocin as love (the human genome project), serotonin in incessant thoughts (limercance and psychology today references) and tryptophan and melatonin in sleep and relaxation (Hall and others…).
- a primitive understanding of how a happy brain and body work (thank you Dr. Brian King and Dr. Seligman) – via survey and brain scan research – where in science genetics are included in the emotional state by birth along with the impact of intentional activity (thought and action) with behavioral factors and steps as well. How can you help a person with a disordered brain get to having a working one, if you don’t have a primitive understanding of the science of happiness? This would be like taking your car to a mechanic and the mechanic saying we know what’s wrong, we know how it got messed up, but we don’t know how it was before it ever got damaged – so we’ll see you next week.
- An understanding of how implicit bias works (thank you Dr. Jussim for highlighting the pros here) and its impact on clients and providers in the narratives used to effect care (and sadly often to elongate it).
- An understanding of how psychosomaticism works, very basically, in that the misfiring of neurons into nerve endings may be a culprit, caught up in a perception that future happiness is not possible (thank you Dr. O’Sullivan).
- An understanding of diagnosis and the impact of stakeholders creating the standards by which they prescribe (thank you Dr. Ken Carter and Pharmacology) and the clouded possibility that even normal can be made sick (thanks to Dr. Joel Paris in talking about the full history of the DSM and the release of the DSM5) particularly his thoughts on “medicalizing normal.”
- A basic understanding of epigenetics – where and how these are break offs if you will, jumping genetics altered by environmental factors primarily (thank March 2012 issue of Scientific American)
- a basic understanding of nutrition, stress, exercise and sleep – with these 4 as tools to improve mental health (thank you mainly Dr. Nick Hall and the Brain Institute)
- a basic understanding of blue light on the brain (thank you for information sharing, Linda Graham, 2018 PSN Symposium)
- a basic understanding of the impact of simple carbs on the body, how the digestive system works in natural selection or maybe even reverse natural selection when diet changes are dramatic (controversial in those who support simple carbs and those who do not; my interest here emerged out of my own weight loss process of dropping 72lbs in a gradual process starting in 2004).
- the impact of words in creating a view, a perspective, a belief and how coding data as true/false in the brain might work as well as tidbits of information about the Reticular Activating System (thank you Dr. Price, Dr. Connoly, and Dr. Hall)
- substance / other addictions treatment (12 step self help models, non-faith and science based recovery models, life satisfaction models, the neuroscience of dopamine and opioid production and scans of addicted brains)
- a basic understanding of stage theories in key areas of the discipline: personalities and craig, crises and erickson, underlying factors hidden away and freud, adolescence and craig, faith and fowler, death and hospice, hypnosis, Westburg, and Kubler-Ross models, love and sex in addiction and in the affirmative (Carnes, Kerner, Cort and the LGBT community at large)
- A medical model view vs an environmental view (thank you Florida State College of Social Work, Steve Serventi, Dr. PAuline Chen in Final Exam)
- The Survivor Personality, by Seibert
- Post-traumatic growth in Option B, by Sandberg
- thought disorders (Dr. Leslie Parsons)
- personality disorders (Joel Paris again!)
- the brain and neurobiological stuff in and for the common uses with clients, patients and people (thank you Dr. Siegel, Dr. Siebert and most recently Dr. Arden, Mind-Brain-Gene!)
- A full understanding of domestic violence in all of its forms (thank you Dr. Wexler)
- A strong grasp of behavior and behavioral modifications (thank you to pioneers unnamed, but to Boystown National Training Center foremost and first and then to my clients who time and again change something – in behavior!).
Note: this page is under development. It is currently comprised of a small summary and more of an emerging bibliography. Links and updates will be added with various updates to this page.
Rev. 7.15.19, 8.13.19; 9.26.20