By Lissa Hunsicker, LCSW

Click here to contact Lissa and/or see her GoodTherapy.org Profile

When a child gets killed, it gets our attention. Consider the words of Nicholas Scopetta, former Executive Director of The Administration of Children’s Services: “people may not understand the intricacies of the system, but they certainly know when a child is killed.”

It’s true. We put down our coffee cup, lift our heads from the paper, take pause in our morning commute. With friends and co-workers, we debate (institutional reform vs. personal responsibility); at home, we reconsider our practice of discipline; in our minds, for the briefest of moments, we become aware of the horror of losing a child and we are enraged. But in time—in a week or two—we move on. As we have to. Read the rest of this entry

A GoodTherapy.org News Headline

A while back, we reported on a clinic in China that was attempting to treat young people whose parents believed they were suffering from “internet addiction,” defined as spending six or more hours per day online, accessing games or pornography rather than studying material, and becoming upset if access was cut off. The clinic was engaged in administering electro-convulsive shock therapy to its clients, a treatment that had many commentators concerned over the therapy’s severity and doubtful efficacy. As ABC News has reported today, the clinic has halted its ECT-related activities, likely causing relief for a range of Chinese adolescents.

© Copyright 2009 by http://www.GoodTherapy.org Therapist Coral Gables Bureau - All Rights Reserved.

A GoodTherapy.org News Headline

The Wall Street Journal’s health blog has picked up on recent concerns over the effectiveness of state-mandated mental health care for outpatients. A New York law established to protect citizens and ensure that those in need of therapy and other treatment modalities receive proper attention, “Kendra’s Law” has been raising questions about whether forced treatment, often involving medication, can ever be an ethical program. Meanwhile, Duke University has recently produced a study showing those treated under the auspices of the law are much less likely to be hospitalized. The final verdict isn’t in, but the argument about Kendra’s Law is certainly heating up.

© Copyright 2009 by http://www.GoodTherapy.org Therapist Anchorage Bureau - All Rights Reserved.

A GoodTherapy.org News Update

The idea of the mystery shopper is fairly prevalent within the world of retail; paid professionals wander stores, seek employee assistance, and go through the motions of making a purchase, all with the intent of scoring the performance of the store involved and filing a report which can help the store to find new ways to improve. Those who are “tested” by mystery shoppers tend to be of mixed in their reaction to the idea; some see it as an honest opportunity to find potential problems, while others feel that it is an infringement on their trust and is a poor way to assess performance. Whether you’re for or against this method, if you’re a mental health professional, you may be hearing about it a lot more often.

The idea of the mystery shopper is being transferred to the platform of mental health treatments, wherein “fake” clients would be staged in care facilities and other treatment settings for the purpose of investigating the quality of care and the professionalism of those involved. The idea, strongly supported by Arthur Lazarus, an important figure within the psychiatry community, has been discussed in the journal Psychiatric Services, and may gain momentum in coming months as more and more therapists and mental health clinics seek to improve their offerings, both on the basis of integrity and under the increasing competition for clients.

Those who oppose the idea have suggested that the practice could present ethical problems within the sphere of psychotherapy and mental health treatment, including the possible issue of mystery clients using resources that those genuinely seeking help could otherwise use. Read the rest of this entry

© Copyright 2009 by http://www.GoodTherapy.org Therapist Austin Bureau - All Rights Reserved.

A GoodTherapy.org News Update

Aversion therapies can be successful in helping people with addictions, who also wish to free themselves from the related behaviors, overcome their difficulties. Such therapies are commonly administered after a more psychodynamic approach is taken; the exploration of the causes of the addiction itself and its role within a person’s life is often able to facilitate positive change, but is sometimes ceased in favor of the more invasive and direct approach of aversion. Such therapy is, for the most part, handled with extreme care and is carried out by seasoned experts, as the potential for psychological harm is a concern.

All the more concerning, then, is the news recently developing in China in regards to a pediatric “internet addiction” clinic which claims to use aversion therapy to help kids kick the online habit. A growing complaint among the country’s parents is the time and energy children spend surfing the web, playing video games, and communicating with friends online, and some parents are apparently desperate for help. The Center for Curing Internet Addiction, located at a hospital in the eastern province of Shangdong, claims to be able to rid children and teens of undesirable internet-related behavior, but its staff as well as its methods are highly suspect. The clinic administers electro-convulsive therapy, or ECT, to children over a course of four and a half months, charging parents extra for early withdrawal from the program. Read the rest of this entry

© Copyright 2009 by http://www.GoodTherapy.org Therapist Chapel Hill Bureau - All Rights Reserved.

A GoodTherapy.org Featured Column written by Judith Barr, MA, LMHC

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Recently the U.S. backed President of Afghanistan, Hamid Karzai, reportedly signed a law which legalizes the rape of a wife by her husband by not allowing her to refuse sex, and prevents women from leaving the house without a man’s permission. This is a blatant attack on womanhood…and another example of the abuse of power that is rampant in our world. But this abuse is now out in the open, ready, waiting, and even screaming to be healed.

Rape is an act of power and control. The act of rape is often a defense against ancient inner wounds to a man’s relationship with his own mother, and a reaction to the feelings of powerlessness he may have had in childhood. How could a man be willing to treat women like this . . . unless he’s still angry at the first woman in his life, his mother?

And why would we, women and men, stay silent and allow such an act to go unchallenged? This too has its roots in childhood wounding. Healing this vacuum where effective use of power needs to be cannot stop at the here-and-now level. We all, men and women, need to heal our own early wounds around being powerless – with mother and anyone else in our childhood, whether it be a particular person, a family tradition, a cultural norm. Read the rest of this entry

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

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“When the generativity and responsiveness of our power is guided by loving concern for the well-being of all, we will have an ethical and sustainable world. Power directed by heart. Heart infused with power. This is the key to right use of power.” ~ Cedar Barstow

“Ethics is the ongoing process of applying principles of higher intelligence to the problems of personal and collective existence, and endowing life with values that support the well-being of all. Ethics is the care we show in affecting the lives of others as well as a sense for where one’s greatest value lies in relation to others. Ethics might be summarized as cause and effect in balance, and applied for the greatest good.” ~Glenda Green

Power and how to use it is in the news. The common concept of power as force with any other use being considered weak and naïve is breaking down and evolving up. Studies (www.nonviolent-conflict.org) conclude “that major nonviolent campaigns have achieved success 53 percent of the time, compared with 26 percent for violent resistance campaigns.” Other studies show that altruism and basic goodness are hardwired in human nature. (Shankar Vedantam, 5/27/07. Washington Post; and Cedar Barstow. (2008). Right Use of Power: The Heart of Ethics, pp. 240-244.) Read the rest of this entry

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

Click here to contact Cedar and/or see her GoodTherapy.org Profile

I have been paying attention to the power paradox phenomenon since I was introduced to it by Dacher Keltner (www.greatergood.org). Having researched and studied who gets power and how they use it when they get it, Keltner learned that “the skills most important to obtaining power and leading effectively are the very skills that deteriorate once we have power.” These are qualities of modesty, empathy, engagement with the needs of others, skill in negotiating conflicts, enforcing norms, and allocating resources fairly. Given that years of social and brain research support the understanding that empathy and altruism are human birthrights, it is surprising (and clarifying) to me to discover that “once people assume positions of power, they’re likely to act more selfishly, impulsively, and aggressively, and they have a harder time seeing the world from other people’s points of view.” (Keltner) You can read more about these studies at www.greatergood.org (Greater Good Magazine, Vol. IV, Issue 3) and on pages 244-247 of my book: Right Use of Power: The Heart of Ethics available at www.rightuseofpower.com.

For those in power differential roles of trust and authority, and all of us are in positions of enhanced power in some areas of our lives, it is extremely important to understand this tendency for inborn empathy and the most effective leadership qualities and skills to deteriorate when we are in positions of power. We have good intentions. We earn power by the socially intelligent use of it. Yet when we get more power, we tend to become more vulnerable to misusing power. When we understand this tendency, we are at great advantage as leaders because we can be extra alert for changes in ourselves and self-correct around them.

Now, why does “power corrupt”? Read the rest of this entry

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

Click here to contact Cedar and/or see her GoodTherapy.org Profile

“The task is to recognize our interdependence, honor boundaries and differences, and remember connectedness.” - Dyrian Benz

“Find the optimum closeness/distance to enable you to experience your OWN unique center of aliveness and awareness, as well as the other’s unique center.” - Mukara Meredith

Good boundaries are a centerpiece for safe and successful relationships. Boundaries are, as well, the space that people consider part of their identity. Skin is the physical boundary. People also have energetic and emotional boundaries. Inadvertent boundary crossings can be very upsetting. Boundaries are very individual, can be negotiated between people, are often communicated non-verbally. They are influenced by cultural values, styles and expectations. Try checking with your clients about precisely what feels to them like the right distance from you. You may be surprised about the amount of variation. Boundaries serve well to provide a consistent container that can define, contain, and limit relationships. Read the rest of this entry

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

Click here to contact Cedar and/or see her GoodTherapy.org Profile

Given that brain research and universal religious values support basic goodness and natural altruism, why is it that there is so much misuse and abuse of power? This is a question I have been tracking since I was a youngster at camp and I became very distressed and just could not understand why one of my tent-mates had stolen another camper’s comic books.

This is a question that has also concerned Dr. Dacher Keltner, a professor of psychology at the University of California. He has done considerable research about who gets power and how they use it once they get it. It seems we have been “guided by centuries of advice from Machiavelli” and more recently “from Robert Greene’s The 48 Laws of Power, (for example: Conceal Your Intentions, Use Selective Honesty and Generosity to Disarm Your Victims, Crush Your Enemy Totally, Keep Others in Suspended Terror) to tend to believe that attaining power requires force, deception, manipulation, and coercion. Indeed, we might even assume that positions of power demand this kind of conduct-that to run smoothly, society needs leaders who are willing and able to use power this way.”

New research on power, supported by brain research on hard-wired morality referred to earlier in this chapter, reveals, however, that “power is wielded most effectively when it’s used responsibly, by people who are attuned to and engaged with the needs and interests of others. Years of research suggests that empathy and social intelligence are vastly more important to acquiring and exercising power than are force, deception, or terror. [However,] studies also show that once people assume positions of power, they’re likely to act more selfishly, impulsively, and aggressively, and they have a harder time seeing the world from other people’s points of view. This presents us with the paradox of power: The skills most important to obtaining power and leading effectively are the very skills that deteriorate once we have power.” Read the rest of this entry

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

Click here to contact Cedar and/or see her GoodTherapy.org Profile

Following last month’s brief notes about Altruism and the Soul, this piece focuses on the development of morality and the ethical values and behaviors that accompany this developmental process. Part III will talk about the Power Paradox and its relationship to the Power Differential. The Power Differential, as mentioned in an earlier column, is the foundation for the need for ethical codes and guidelines for people in professional positions of power and authority. The Power Paradox derives from research pointing to the need for increasing sensitivity to the impacts of the Power Differential on professionals themselves.

Ethical use of power begins in empathy and altruistic pleasure. We are born with a basic moral compass, based in empathy and the natural desire to take action on behalf of others. This is most obvious in the outpouring of care for a family member or a situation in which one is directly involved. Simple moral decisions activate a straightforward brain response. The Snyders have spent a lifetime studying young children as persons. They have consistently found that children have an inborn pre-disposition for justice and caring. “Unless they have been dehumanized by adults….children reveal the capacity to be empathically attuned to each other, to co-create a ‘justice culture,’ to support fairness, safety and the restoration of relationship, and to be naturally interested in what works for the well-being of all.” This is what we would expect from our brain wiring. Of course, when this brain wiring in the frontal lobes is damaged or inoperative, people suffer from a complete lack of empathy and conscience, clinically labeled psychopathy. While not all who meet the definition of psychopath are violent, they live with a lack of the normal empathy and conscience that guides behavior. When in leadership positions, and they are there, these people are particularly difficult if not impossible to deal with.
Read the rest of this entry

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

Click here to contact Cedar and/or see her GoodTherapy.org Profile

“Altruism is a natural expression of human development and a healing force in society…Caring coupled with imagination and enterprise is the essence of creative altruism. If we ignore our capacity for compassion and care, we diminish the texture of our lives, our ability to help others heal and grow, and our collective potentials for social healing. By opening ourselves to the reality of shared being, we enhance the wonder and richness of the world and liberate the creative and constructive energies of the human heart, mind, and spirit.” —Tom Hurley

Karen Armstrong adds to her statement about the need for an ethic of compassion: “The early prophets did not preach the discipline of empathy because it sounded edifying, but because experience showed that it worked. They discovered that greed and selfishness were the cause of our personal misery. When we gave them up, we were happier. Egotism imprisoned us in an inferior version of ourselves and impeded our enlightenment.” Fascinatingly, recent neurological research by Moll and Jordan Grafman has shown that taking action in the best interests of others is coded in the brain. In a study in which they scanned the “brains of volunteers as they were asked to think about a scenario involving either donating a sum of money to charity or keeping it for themselves,” the results showed that “when the volunteers placed the interests of others before their own, the generosity activated a primitive part of the brain that usually lights up in response to food or sex. Altruism, the experiment suggested, was not a superior moral faculty that suppresses basic selfish urges, but rather was basic to the brain, hard-wired and pleasurable.” (Moll and Jordan Grafman are neuroscientists at the National Institutes of Health. Quote is from an article by Shankar Vedantam, The Washington Post, May 28, 2007.) There is an surviving and thriving impulse and advantage for those who develop and use their capacities for social intelligence. This social intelligence is accessed through the social engagement nervous system referred to on page 91 of Right Use of Power: The Heart of Ethics. Read the rest of this entry

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

Click here to contact Cedar and/or see her GoodTherapy.org Profile

What a pleasure to go to the site here at GoodTherapy.org and find responses to the Ethics Column from Sam and Sally and Meg and Rob. I want to appreciate you for your interest in ethics and for your thoughtful and thought-generating words.

Grief and the Sensitivity Cycle

Both Meg and Rob were thinking about grief. So a bit more about that. Grief, of course, has it’s own rhythm and pace, and is a process….neither to be rushed nor clung to. I’m reminded of the Sensitivity Cycle from the Hakomi Method. The Sensitivity Cycle describes the process of becoming more and more sensitive and effective. It has four phases: clarity, effectiveness, satisfaction, and relaxation. All four phases need attention and organically move on to the next. In thinking of grief, for example, first you need to be clear about what you’re grieving, then take some kind of effective action, then find and integrate some satisfaction from the action you took, and then relax and let go—so that you will have made space for a new cycle. It is easy to get stuck at each phase and with grief it seems that the most common place to get stuck is in letting go. Getting unstuck and letting go when it is time seems to involves having a “gut” sense of the timing. It also involves trusting that letting go of the process of grieving for a person, thing, or event, doesn’t mean letting go of it all, but rather knowing that you have integrated it, or the learning from it, within you.

In responding to Sally who is looking for some more depth, I’d like to say something about two kinds of ethical decision-making edited from pages 59-61 of my book: Right Use of Power: The Heart of Ethics. I find that we as professionals most often think of ethical decision-making simply and solely as the second kind I describe as complex decision-making without putting conscious attention toward ordinary moment, every day kind of ethical decision-making. Read the rest of this entry

The items listed below are significant red-flags and important information for anyone in therapy or considering therapy. If any of the following red-flags appear during the course of your counseling, it may be time to reevaluate your counselor or therapist. Should you recognize one of these red-flags, the first step, in most cases, is to discuss your concern with your counselor. Try talking candidly about what’s bothering you. A good therapist should be open and willing to understand your concerns. If your counselor doesn’t take your concerns seriously or is unwilling to accept feedback, then it’s probably in your best interest to consult with another therapist about it. Most therapists mean well and are willing to take accountability for their own “stuff.” So, it’s also important to give your therapist the benefit of the doubt…all people make minor mistakes. And sometimes what people think is their therapist’s issue, is actually their own. These “blind spots” can be the most difficult to see and are well worth taking about with your therapist.

It’s also important to note that the following red-flags have varying degrees of significance. Some of them are very serious violations of ethical standards, such as a therapist attempting to have a sexual relationship with a client. There is no exception to this rule and if you find yourself in such a situation you are advised to report to the state professional licensing board and consult with other professionals. However, a number of the red-flags listed below do have “exceptions to the rule” and depend partly on the context. For example, it’s generally unacceptable for therapists to have dual relationships with their clients. So if a counselor is treating the neighborhood barber for his depression, the counselor goes to a different barber to avoid confusing the “client-therapist” relationship. However, in small communities it can be impossible to avoid certain dual relationships. Ethical guidelines are flexible enough to take this, and some other exceptions, into account.

In no particular order, it is a red flag if you find that your: Read the rest of this entry

© Copyright 2008 by http://www.GoodTherapy.org Therapist Columbia Bureau - All Rights Reserved.

A GoodTherapy.org Featured Column written by Cedar Barstow, M.Ed., C.H.T.

Click here to contact Cedar and/or see her GoodTherapy.org Profile

Ethics as Soul Work

I slept and dreamt that life was joy;
I awoke and saw that life was service;
I acted and behold, service was joy.
–Rabindranath Tagore

I appreciate your interest in using your personal and professional power with wisdom and compassion. I think of ethics as right use of power. In fact, right use of power and influence is the biggest container for ethics since it includes social consciousness and personal development. In this greatest context, it is about reverence for life, treating all people with respect, and acting honorably. It requires a high level of consciousness development and understanding of both harm and empowerment.

This context for ethics includes and honors the value of prescribed codes and guidelines and goes beyond into the realm of repairing harm, restoring relationships, and promoting well-being. Ethical behavior in this framework requires a high level of consciousness development and understanding of both harm and empowerment.

This is the first of a series of articles devoted to exploring issues of power in our personal and professional lives. Expect a new column every 4-6 weeks.

In working with ethical sensitivity from a soul deep point of view, I think there are a number of things that are asked of us as healers and as human beings. Read the rest of this entry

Written by Cedar Barstow, M.Ed., C.H.T.

Click here to contact Cedar and/or see her GoodTherapy.org Profile

RIGHT USE OF POWER IS URGENTLY IMPORTANT.
Right use of power and influence is surely one of the most important issues facing us in our emerging globally interdependent world. Interest in right use of power takes us in the dynamic realms of roles, relationships, and trust. We engage with finding out how we impact others and then with developing the skills and compassion to be more and more effective. This is inspiring and valuable process.

UNDERSTANDING MORE THAN ONE ROLE
Some of you are clients or potential clients. Some of you are therapists or helping professionals. My intention is for this article to be of value in whatever role you are in. All of us have personal experience on both sides of relationships of trust: as clients, patients, students, children, committee members….and as therapists, social workers, parents, teachers, guides, coaches, committee heads, body workers, office managers. We have a sense for what each role feels like, but it is often hard to remember what the other role experience is. One of the hallmarks of the right use of power is to make the dynamics and expectations of each role open, clear, and understood by all. Read the rest of this entry