Alex and Me

Last night I finished reading Dr. Irene Pepperberg's book, Alex and Me. If you are curious about her work, check out The Alex Foundation. I was recently given the book by someone who knows I share my home with Toby, and African Grey parrot.

Pepperberg weaves her own life story with the research discoveries made during over 30 years of study with African Grey parrots. Through exhaustive and rigorous research Pepperberg demonstrated the amazing cognitive abilities of the African Grey. Among other things, she demonstrated that he possessed  more than 100 vocal labels for objects, actions, and colors; could identify some objects by what material they were made of; could count sets of objects up to six; developed his own "zero-like" concept; could infer connections between written numbers, object sets, and the vocalization of the number; and had the concept of phonemes which are the sounds that make up words.

A pretty impressive bird!

However, I was more struck by Pepperberg herself. Her personal story, as revealed by her book, is not an easy one. Her research has not always been popular or well received by peers. Funding for her work has not come easily. Despite the difficulties, she stuck with her passion and her science, opening up a window into the unseen world of nature.

I finished the book thinking of how often the unconventional, unorthodox, or different viewpoint is squashed by a society that values sameness. While we often give lip-service to diversity, we very rarely celebrate it or encourage it. I was left thinking about how much we lose when the chorus of the masses drown out a new voice asking us to see something in a different way.

I'm glad Dr. Pepperberg used her voice and opened up a new world of discovery for all of us. I hope we all find a way to learn by her example and find the courage to pursue our individual voices in a disciplined, organized, and thoughtful way.

Friday News Roundup

Grocery Chain's Decision to Drop Mental Health Coverage Raises Concerns

As I feared, the loopholes in the coming requirement for health insurance plans to offer parity for mental health treatment are starting to cause problems. One Wisconsin supermarket chain has cut the mental health portion of its health care benefit "because it will be too costly due to the passage of the federal mental health parity law." Shame on them!

Could Acetaminophen Ease Psychological Pain?

A team of researchers at the University of Kentucky uncovered evidence indicating that acetaminophen, the active ingredient in Tylenol, may blunt social pain. On a self-report measure of hurt feelings, participants taking the medicine reported lower levels of social pain than those who were not taking the medication. Watch out for side effects: too much acetaminophen can be toxic!

How Psychotherapy Works

Bruce Wampold, Ph.D. is the author of the recent book, "The Great Psychotherapy Debates." In that book he puts together empirical research on psychotherapy using rather sophisticated methods. He even places that research in an historical and anthropological context. In this article, he answers questions about how psychotherapy helps people. He notes the differences between different treatments in terms of benefit to patients are small if not negligible as long as the treatments are intended to be therapeutic, are delivered by competent therapists, have a cogent psychological rational, and contain therapeutic actions that lead to health and helpful changes in a patient's life.

Happy Holidays

What's in a Name?

There are so many different kinds of psychotherapists in the world practicing so many different kinds of psychotherapy. At one point in my post-doctoral fellowship the training director gave us a hand out with a non-exhaustive list of over 300 different kinds of therapy! We spent some time sorting through that list--what had we heard of? What have we tried? What do we think works? What do we think is little more than a modern snake oil?

Different kinds of psychotherapy would be an interesting discussion. I'll save that for a future blog post.

Today I thought it would be helpful to define the alphabet-soup bowl of terms one encounters when looking for a therapist. Ph.D.? MSW? LMHC? Psy.D.? M.D.? What are all these letters and what do they mean to you?

The importance of these letters depends a lot of what kind of question you are asking. If you are looking for someone with a specific kind of training, skill set, or viewpoint, these letters mean something. If you are looking for someone compassionate and can listen, the individual letters mean somewhat less.

Most terms (psychologist, psychiatrist, social worker, counselor) are terms that are set aside by the Commonwealth of Massachusetts to legally define a profession. To call oneself a psychiatrist, for example, one must have a medical degree. Likewise to call oneself a psychologist, one must have a doctoral degree in psychology. The Commonwealth (and every other state) does this to ensure public safety: these professions are regulated by law so that the public can be assured that they are going to a professional with a specific kind of training.

Here is a quick run down of the different kinds of professions that are licensed and regulated by the Commonwealth. Today's blog post is going to be on a basic level: in the coming weeks I'll write more detailed blog entries about the differences between how the different professions view people and their problems.

Psychologist


Psychologists are licensed in Massachusetts by the Board of Registration of Psychologists. According to statue, a psychologist is defined as the following:

Psychologists observe, describe, evaluate, interpret, and modify human behavior by the application of psychological principles, methods and procedures, in order to assess or change symptomatic, maladaptive or undesired behavior. Psychologists' work may focus on issues such as interpersonal relationships, work and life adjustment, personal effectiveness, and mental health. The practice of psychology includes, but is not limited to, psychological testing, assessment and evaluation of intelligence, personality, abilities, attitudes, motivation, interests and aptitudes; counseling, psychotherapy, hypnosis, biofeedback training and behavior therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, and the psychological aspects of physical illness or disability; psychoeducational evaluation, therapy, remediation, consultation, and supervision. Psychological services may be rendered to individuals, families, groups, and the public. Certification as Health Service Provider (HSP) is required in order to independently offer health services to the public or to supervise such services. Psychologists may also teach and do research (license not required), and consult to organizations. The title "psychologist" is protected by law and cannot be used unless the individual is licensed by the Board   

A psychologist must have a doctoral degree (Ph.D., Psy.D., Ed.D.) which normally involves 5 to 7 years of study beyond an undergraduate degree. During school, psychologists-in-training normally complete between 1,500 and 2,000+ clock hours of supervised psychotherapy experience. Prior to graduation psychologists-in-training are required to complete a minimum of a 1 years 2,000 clock hour internship. Prior to licensure, the Commonwealth requires an applicant to receive a passing score on two different examinations and have had a minimum of one full-time year of supervised experience.

Social Work


Social Workers are licensed in Massachusetts by the Board of Registration of Social Workers. According to statue, a social worker is defined as the following:

Social workers provide services to consumers as defined by the statutes and described in the regulations. Generally, social work professionals provide services to individuals, couples, families, groups, and communities directed towards specific goals. They may also assist or refer individuals or groups with difficult day-to-day problems, such as finding employment or locating sources of assistance. Social workers at an advanced level (LCSW, LICSW) may diagnose and treat emotional and mental disorders. Some social workers organize community groups to work on specific problems and help to create social policy and planning.

A social worker must have a masters degree (MSW, MSSA, etc.) which normally involves 18 months to two years of education beyond an undergraduate degree. During the course of training social work programs require a minimum of 900 hours of supervised clinical experience. A social worker may, but is not required, to have a doctoral degree (Ph.D., DSW, etc.). To be an Licensed Independent Clinical Social Worker (LICSW) the commonwealth requires an social-worker-in-training to have at least 3,500 hours of post-masters social work experience under the supervision of a social worker and pass an exam. In order to be a Licensed Clinical Social Worker (LCSW) one is not required to have any documented post-masters experience and pass an exam. 

Licensed Mental Health Counselors (LMHC)


LMHCs are licensed in Massachusetts by the Board of Registration of Allied Mental Health and Human Services Professionals. According to statue, a psychologist is defined as the following:

Mental Health Counselors render professional services to individuals, families or groups. They apply principles, methods and theories of counseling and psychotherapeutic techniques to define goals and develop a treatment plan of action aimed towards the prevention, treatment and resolution of mental and emotional dysfunction and intra or interpersonal disorders.

A LMHC must have a masters degree (MA, MS, etc) which normally involves 2 years of study beyond an undergraduate degree. They can, but are not required, to have a doctoral degree (Ph.D., Ed.D., etc.). During school, LMHCs-in-training normally complete a practicum of 100+ clock hours of supervised psychotherapy experience. Prior to graduation LMHCs-in-training are required to complete a minimum of a 600 clock hour internship. Prior to licensure, the Commonwealth requires an applicant to receive a passing score on an and have had a minimum of two full-time years of supervised experience.

Licensed Marriage and Family Therapists (LMFT)


LMFTs are licensed in Massachusetts by the Board of Registration of Allied Mental Health and Human Services Professionals.  According to statue, a psychologist is defined as the following:

Licensed marriage and family therapists apply principles, methods and therapeutic techniques to individuals, family groups, couples or organizations for the purpose of resolving emotional conflicts, modifying perceptions and behavior, enhancing communication and understanding among all family members and preventing family and individual crises. Individual marriage and family therapists may also engage in psychotherapy of a nonmedical nature with appropriate referrals to psychiatric resources. In addition, professionals engage in research and teaching in the overall field of human development and interpersonal relationships.

A LMFT must have a masters degree (M.A., M.S., etc) which normally involves 2 years of study beyond an undergraduate degree. During school, LMFTs-in-training normally complete 400+ clock hours of supervised psychotherapy experience. Prior to licensure, the Commonwealth requires an applicant to receive a passing score an examination and have had a minimum of two full-time years of supervised experience.

Psychiatrist


Psychiatrists are licensed physicians in Massachusetts by the Board of Registration in Medicine. I was not able to locate a specific legal definition of a psychiatrist from the Commonwealth. According the the American Psychiatric Association:

A psychiatrist is a physician who specializes in the diagnosis, treatment, and prevention of mental illnesses and substance use disorders. It takes many years of education and training to become a psychiatrist: He or she must graduate from college and then medical school, and go on to complete four years of residency training in the field of psychiatry. (Many psychiatrists undergo additional training so that they can further specialize in such areas as child and adolescent psychiatry, geriatric psychiatry, forensic psychiatry, psychopharmacology, and/or psychoanalysis.) 

A psychiatrist must have a medical degree (M.D., D.O.) which normally involves four years of medical school beyond an undergraduate degree. A psychiatrist-in-training then completes a rotating internship (one to four years) divided between a number of different medical settings; a psychiatric residency lasting four to six years; and receive passing scores on several different exams. 

Tuesday's Tweet

What is certain is that I am sometimes this, sometimes that. Sometimes pleased, sometimes not; sometimes confident, sometimes not; sometimes compassionate, sometimes not. The ice doesn't melt at my whim. It doesn't melt no matter how well I understand its origins or believe I understand its origins. It may not melt despite my persistent efforts to change the circumstances that I believe to be maintaining it. In such cases what else is there to do but shiver and go on about living? -- David K. Reynolds

Friday News Roundup

Since signing up for Twitter I've become deluged with information. Some of it is rather banal ("I'm heading out for  a cup of coffee") while other is much more interesting (breaking news from the environmental summit). In an effort to slow down the flow of information enough for me to understand it I'm going to experiment with aggregating tweets that I find most interesting and post it here on a Friday News Roundup.   Think of it as a companion to the Wednesday Smile that I post on Maggie's blog.

• Doodling Improves Memory and Concentration. Jackie Andrade had 40 participants listen to a monotone two and a half minute phone message. Each were told the message would be dull , they should not memorize it, but they should write down the names of the people who would be attending the party that the message discussed. Half the participants were instructed to doodle as they listened . The study indicated that those who doodled could remember more names (7.8 for doodlers vs 7.1 for nondoodlers, which represented a significant difference). When presented with a surprise memory test later, those who doodled remembered 29 percent more details. It has long been taught that multitasking reduces productivity: this research suggests otherwise. 

• Evidence Does Not Support Theory of Different Learning Styles. It has become common belief that people exhibit different learning styles (visual, auditory, etc.). An industry full of tests to measure these styles and educational tools to teach to these styles has grown. However a report that reviews the existing literature finds that while there are many studies that show the existence of different kinds of learns, those studies have not used research methods that would make their findings credible. The article concludes that research has not shown that people learn differently, at least in the ways the learning-styles proponents claim, and thus the widespread use of learning-style tests and associated teaching tools is a wasteful use of educational resources.

• Antidepressants Help Suicidal Youth. Many parents have expressed concerns about their adolescents taking antidepressants. The FDA required a black box warning on antidepressants about suicide risks with youth and there was significant reports in the media. This is however much  more complicated than a black box warning. A study from Ohio State found that the use of antidepressants in adolescents was related to a dramatic reduction in hospital readmissions.

Brain Music Therapy

Now here is an interesting article. The Department of Homeland Security is examining an existing biofeedback technology to help with sleep. They are investigating the use of brain music therapy which has been in use since the early 1990s to treat medication conditions such as insomnia. Apparently brain waves are recorded and run through algorithms that analyze the waves and translate them into a music composition. According to the company Human Bionics, which sells this technology, these musical compositions are effective and scientifically proven treatments for stress, insomnia, anxiety, and depression. The technology has also been "found to increase productivity and concentration, and help reduce headaches."

I've not done the background research to see if these claims are reasonably true. The sample clip, however, makes for pretty music (though a bit repetitive).