Why therapists can’t prevent violence

via Wikimedia Commons[Originally published May 2014.] Last week in Isla Vista, California, Elliot Rodger killed six people before taking his own life. His family says he was seeing multiple therapists. Meanwhile, in the California legislature, discussion of a bill that would mandate additional suicide prevention training for therapists has focused on research showing that more than 30% of those who commit suicide had seen a mental health professional within the past year. Why can’t therapists do more to stop violence among our own clients?

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I took the California MFT Clinical Exam and the National MFT Exam. Here’s how they compare.

Sarah Pflug via Burst / Licensed under Creative Commons ZeroI just took the California MFT Clinical Exam and the National MFT Exam within a month of each other. When scheduling both of these exams, my hope was that I could study once, and then ace both. Here, I’ll outline the similarities and differences I noticed between the two exams.

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Graham-Cassidy health care bill would be disastrous for US mental health care

US Capitol domeThe US Senate may take action this week on the Graham-Cassidy health care bill, a last-ditch effort by Senate Republicans to repeal and replace the Affordable Care Act. If Graham-Cassidy becomes law, the consequences for US mental health providers and their clients would be disastrous.

The nonpartisan Congressional Budget Office will not score the bill before a September 30 deadline for Senators to vote on it. But estimates suggest that under the bill, at least 16 million Americans would lose health insurance entirely after 10 years, given the bill’s similarity to prior Republican health care bills. This would leave millions paying out of pocket for mental health care that is currently covered by insurance.

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“At least it’s not cancer.”

Courtesy Emma JaegleI was working in a residential treatment center for teens. It was a typical mid-week day, and I was supervising “school time,” a period where clients are able to work on their treatment assignments and homework from their schools back home. Often during this hour, the primary therapists would pull the clients for individual sessions. I happened to know that today was the day that Nicole* was going to be given her diagnosis of depression, and I was prepared to help her process her emotions should she need coaching after her return from session. Sure enough, Nicole returned from her therapist’s office with a solemn look on her face. When she sat down away from her peers, I walked over to her and asked, “How did it go?”

She let out a sigh, “Well, I found out my diagnosis.”

I nodded. “I see. What’s that like for you?”

“I guess it’s better to know what’s going on and have an explanation for everything. At least it’s not like I have cancer!”

That comment gave me pause. I thought: But I have cancer.

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Talkspace forces therapists to break rules. The rules may be the problem.

Matthew Henry / Burst / Licensed under Creative Commons ZeroApp-based therapy platforms may well represent the next evolution of psychotherapy practice. I praised Talkspace a few years ago for offering access to mental health care for many who otherwise would never find their way to a therapist’s office. But the platforms — Talkspace, Betterhelp, and the like — have run into controversy over their confidentiality policies. Therapists using these apps may have little to no ready access to the client’s full name, address, or other information necessary in an emergency.

Read moreTalkspace forces therapists to break rules. The rules may be the problem.