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An Open Letter to the North Dakota State Board of Psychologist Examiners

If you have been following my career antics, you know that I have been applying for licensure in North Dakota. The folks at ADHD Online had ONE psychologist serving the state, and that psychologist retired. Rather than telling the people of North Dakota, “Sorry, no accessible ADHD testing for you,” they offered to help me get licensed.

I am happy to say that I jumped through all the hoops, crossed all the Ts, dotted all the Is, and received approval to practice!

Photo by Matheus Bertelli on Pexels.com This is what comes up when you search “North Dakota” in free stock photos and it’s…not wrong.

As I was completing the qualifications for licensure, though, I stumbled upon a state law that unsettled me. North Dakota requires psychologists and other professionals to register any client that they diagnose as autistic in a state registry, including completing an extensive, two-page document with detailed personal information about each client. The North Dakota Department of Health has information about this law on their website.

Reporting your clients is mandatory, and failure to report a client results in a $1,000 fine plus a report to the board, which could cost your license to practice. What if an autistic client does not want to be registered with the state? Too bad! According to the FAQ page on the website, it’s legal because North Dakota says so.

When I first came across this law in my test prep materials for the state licensing exam, I thought they were testing me. I thought, “This cannot be legal. They want to see what I do when I find a law that directly conflicts with my ethics code.” It wasn’t a test. But here is what I do when confronted with an unethical law.

I will not be conducting autism evaluations in North Dakota while this law is in effect because I cannot do so in a way that is simultaneously legal and in accordance with my professional ethics code and personal moral values.

This does not affect my work with ADHD Online because, for some reason, the North Dakota government only feels that autistic people need to be put on a list.

However, I have written a letter to the North Dakota State Board of Psychologist Examiners and copied the Department of Health and Governor Doug Burgum detailing how this law violates the APA ethics code as well as international laws regarding human subjects in research. My letter to the board is attached to an email noting that I am happy to do whatever I can to help support the board in lobbying to change this law.

You can read my letter to the board here:

What can YOU do? You can report this unethical law to the Department of Justice. The Autism Support Society shared detailed instructions via this Twitter thread about how to do this, and if the DOJ gets enough complaints, they can pressure North Dakota to repeal the law.

If you live in North Dakota, especially if you fall under this mandatory reporting law, please join me in writing to your licensing board, the Department of Health, and the state government demanding that they repeal this law.

BE THE CHANGE, friends. For more information about how to support autistic folks, please check out the Autistic Self-Advocacy Network.

Featured

May You Live in Interesting Times

Gloriosa by Jitney58 is licensed through CC-BY-2.0

There is conflicting information about the origins of this expression, but it is generally agreed to be a curse. We are watching history be made as each day goes by, and frankly, I wish I lived during a more boring chapter of future history books. At the same time, though, it is through the difficult times that we grow.

As a psychologist, I’m used to walking with people through the difficult times. I usually can’t offer a quick or simple fix, but I can be there with tools, hope, and connection.

My goal in creating this site is to offer resources to a wide audience during these trying times. I want to reach those who share my drive to help children and provide them with the tools to do this effectively: teachers, social workers, counselors, and fellow psychologists. If there are specific resources that you would like to see, please let me know, and if I have the appropriate skills and knowledge, I will do my best to make it happen.

Thank you for joining me during these interesting times. Follow my site to stay up-to-date with resources.

Coming Soon: Continuing Education

I am excited to announce that Resiliency Mental Health is applying for sponsorship with the American Psychological Association so that I can continue creating content like my Professional Wills for Therapists seminar and start offering educational credit!

Photo by Pixabay on Pexels.com

Fortunately, since I have been helping the people at PESI create content that meets APA’s standards for continuing education, I already know quite a bit about their standards and requirements to make sure that my content is high-quality and useful for the providers who learn from it.

I also connected with a colleague who has helped businesses get this sponsorship in the past, and she has agreed to consult with me in this process.

So stay tuned for updates! And if there’s a topic you want more education on, tell me, and I’ll see if I can make it happen!

What Makes Forensic Psychologists Different From Other Psychologists?

Today’s post is brought to you by a guest blogger, Roxana Sue Huxley. Roxana reached out to me recently and asked if she could share some content to Resiliency Mental Health.

Roxana is a writer who has written pieces on mental health in the past, and she is sharing today some information on forensic psychology and what special training makes someone a forensic psychologist.

Forensic psychology is a relatively new field. It involves the application of psychological principles in the legal arena, thus forming an intersection between human behavior and the law. Forensic psychologists provide critical input as psychology elevates understanding and provides perspectives on many wide-ranging issues like child abuse, sexual offenses, and mental illnesses.

But while their practice is in psychology, forensic psychologists require further specialized training to carry out their unique tasks. Here’s what you need to know about how they are trained, who they work with, and what they do.

Training

General psychology curriculums focus on major content areas in psychology. This includes general theories and basic research methods applicable to the field. Courses commonly involve developmental, cognitive, social, and clinical psychology, as well as neural studies.

Forensic psychologists, on the other hand, study more than just general psychology. They also require more specialized training, which is why forensic psychology degrees also offer experiential learning opportunities and course work in criminal justice and the social sciences. This makes forensic psychology degrees much more specialized. Not only do they acquire a broad understanding of human behavior, they also know how to apply psychological principles legally and socially.

Patient Base

Clinical and counseling psychologists often work one-on-one with patients. They focus on treating mental health conditions or counseling patients. From here, they identify and address stressors that may be causing patients difficulty. Generally, however, psychologists with particular specialties work with a specific patient base and apply varying methods conducive to their cases. Recreation therapists utilize activity-based interventions to make therapy more enjoyable, while military psychologists work with service members and their families to help them cope with the stress associated with military life. Similarly, forensic psychologists provide counseling, particularly to victims of crime. They can also extend therapy services to individuals convicted of crimes.

Tasks

Most psychologists provide counseling and treatment in varying settings, including schools, hospitals, clinics, and community organizations. Because forensic psychologists work in the legal sector, they usually work in prisons, hospitals, medical examiners’ offices, forensic labs, police stations, research centers, and universities. They can also serve as consultants.

Forensic psychologists use psychological assessments to help determine the outcome of legal cases. For instance, they can assess how fit a parent is for child custody or whether an offender should leave prison or should remain incarcerated. They might also be in charge of observing and interviewing those involved in cases, writing reports and research articles, and providing expert psychological testimonies in court.

In these cases, criminal psychologists have a similar role to forensic psychologists. But whereas criminal psychology focuses on criminal behavior, forensic psychologists are trained in criminal and civil law. This makes the forensic psychologist more suited to operating outside the justice system — specifically when it comes to social work.

Skills Needed

All psychologists deal with human behavior. This means they must be empathetic and compassionate. However, forensic psychologists have to balance these characteristics with objectivity. This is because their assessments are taken seriously from a legal standpoint. Ultimately, they can determine critical factors in the lives of both the victims and the perpetrators of a crime. Because criminal justice cases can be pressure cookers, forensic psychologists must also possess strong mental fortitude.

Forensic psychologists require extensive training to carry out their tasks successfully. While the job can be challenging, forensic psychologists ensure that the criminal justice system carries out investigations and decisions with the utmost consideration.

Post contributed by Roxana Sue Huxley for resiliencymentalhealth.com

Why I Don’t Conduct Autism Evaluations in North Dakota

I am writing today’s post to provide some information for clients and potential clients about my practice.

If you have reviewed RMH Therapy’s website, you will see that one of my areas of specialization is supporting autistic people, including evaluating for, diagnosing, and identifying autism in both children and adults. I take a neurodiversity-affirming approach to my practice, and I believe that although many autistic people experience difficulties, autism is not something to “fix” or “cure.”

That being said, many autistic people benefit from supports and services, and part of my job is helping people access resources that can help them have their best life (whatever that means to them individually).

When I applied for licensure in North Dakota, I learned that the state has a mandated reporting law for autism diagnoses. Basically, when a provider diagnoses someone with autism, they are required by law to complete a form and submit it to the state Health Department. This form includes detailed personal information about the autistic individual and their immediate family. They claim it’s for research and to make resources more accessible. I have spoken with parents, providers, and autistic folks in North Dakota, and all have said they have not been able to get information about what research is being done with this information or seen evidence that the database has increased access to support or care.

Other states have similar databases. However, I am told that some of these databases only include anonymous information that is actually used to help autistic people. (For example, a parent shared with me that their state uses data about the total number of autism diagnoses made each year to free up funds to help pay for occupational therapy or provide classroom accommodations.) There are also other states that have databases like the one in North Dakota.

I have reached out to the Department of Justice about this law and have not heard back. I have reached out to the Civil Rights Office and been told that this is not illegal. I have reached out to the North Dakota Board who oversees my license and have not gotten a response. I have reached out to the American Psychological Association and been told they will get back to me (back in December 2021, I believe). I have reached out to state representatives and gotten some feedback, but since I am not a voter in North Dakota, it is very difficult for me to make progress that way.

According to the Health Department, if I fail to register clients, I can be fined $1,000 per incident and risk losing my license. According to my ethics code, I cannot violate client confidentiality under these circumstances.

This puts me in a Catch-22. I cannot ethically follow this law, and I cannot afford to risk my license and pay $1,000 for each client who comes to me for an autism evaluation.

Until this law is repealed or the database is changed to only include de-identified data, I unfortunately cannot and will not provide evaluations for autism in North Dakota. I simply will not put my clients in the position where they are on a government list based on their diagnosis.

If you have followed me for a while, you have seen me address North Dakota’s autism registry in the past. More information about my attempts to get this practice shut down is available here, along with information about what you can do to fight this with me.

PCIO Games Walkthrough Update

I’ve previously shared a PCIO games walkthrough here for those who bought games from my TPT store. My friend Becca recently showed me that there’s some difficulty getting the PCIO file out of the zip folder, so I’ve made another walkthrough to address that step! I hope it is helpful.

As always, if you purchased a game from me and are having trouble getting it to work, send me a message and I’m happy to help!

Here is how to get those PCIO files out of the zip folder!

Walkthrough Video

Therapy and Social Media

The internet is simultaneously a wonderful and overwhelming place. Thanks to social media, pretty much anyone can reach out to pretty much anyone else at any time through dozens of different portals.

Photo by Pixabay on Pexels.com

The internet is a minefield when you are a therapist. Many (myself included) choose to be public with our names and credentials on social media in an effort to share accurate information about mental health, break down stigma, and provide resources to the public.

As a graduate student, I was discouraged from putting my own name out there for clients to potentially find. But in the modern world, if clients want to find information about me, they will be able to find things. It’s up to me to decide whether or not I am going to be the one creating the content they will find.

For example, websites like CareDash post inaccurate information about my practice without my consent. They are still refusing to take my profile down or allow me to correct it without accepting their terms of service. If I did not curate my online presence, many clients’ first impression of me might be through CareDash. So, I create accurate profiles on sites like Haley to ensure that clients find accurate information if they choose to look me up online.

A friend of mine who works with people with eating disorders was listed on CareDash as “treating obesity,” which is in direct conflict to her framing and approach to treatment. She pointed out the possibility that a client could see that listing, think she had misrepresented herself to them, and discontinue treatment. Obviously, this could be damaging to clients, not to mention the possible impact on her practice.

In addition to ensuring clients see accurate information about my practice, social media creates a difficult-to-navigate maze of random interactions. Imagine running into a client at the grocery store, except we all live at the grocery store 24/7, and many of us are in disguise.

What happens if a potential client follows my Twitter or tries to add me as a friend on GoodReads? What if their profile is anonymous, and I don’t realize they are a client? What if they comment on my post identifying themselves as a client?

This is why I have a Social Media and Technology Policy at my practice. It is hard to capture every possible scenario, especially with new sites popping up every day and technology constantly evolving, but in my policy, I address:

  1. Connections and friend requests
  2. Clients following me and my policy on not knowingly following clients
  3. How I will respond if they choose to interact with my posts
  4. Messenger and other non-secure portals on social media (and how I will not read or respond to messages from clients through these methods)
  5. Search engines and directories
  6. Business review sites and feedback

I will continue updating my policy as needed, but this is a starting point to ensure that clients understand my professional boundaries when it comes to the internet, know where to find accurate information about my credentials and practice, and what they can expect from me if we encounter each other online.

If you are in practice and want to create a social media policy, feel free to use mine as a template or starting point. A PDF of my policy is below:

Telehealth Activity: Pet Adoption

As a child of the 90s and early 2000s, I was raised on Tamagotchis and Neopets. They were so much fun, but also stressful as I tried to keep them alive.

Virtual pets can help teach responsibility and build attachment with the pet. There is an element of creativity as well.

I have written before about using an activity such as a Butterfly Garden as an intervention that can be incorporated across several sessions, teaching patience and building on different themes and skills over time. Virtual pet adoption is another way to tap into these themes but gives the client more control over the intervention.

Recently, I learned about Chicken Smoothie. Chicken Smoothie is a website that allows you to “adopt” various virtual pets. Some are animals your client is probably familiar with, like cats and dogs, and others are fictional, like a butterfly wolf.

Chicken Smoothie Logo

On the home page, you can click “Adopt” to choose what type of pet you want. If you create an account, you can adopt an unlimited number of virtual pets, but you can also adopt a pet without creating an account and just bookmark the page that comes up.

This gives you options as a therapist: you can create an account and use it with various clients (just keep your own secure document indicating which pet belongs to which client), or you and your client can bookmark the page for the pet you created. Using the bookmark feature allows your client to check on their pet in between sessions.

Different species have different gestation periods, which are estimates rather than hard timelines. For instance, I adopted a butterfly wolf before writing this post. His name is Jasper. The site says he will grow up in about 20 days but could develop “much faster.” Below is my butterfly wolf baby, pictured next to information about his growth cycle.

Jasper the baby butterfly wolf

Virtual pets on Chicken Smoothie don’t need to be fed or cleaned up, so they require no maintenance between sessions. You and your client can watch their pet grow and use this as a jumping off point to discuss their own growth. You can talk about times the client has had to wait for something and explore how it feels to not know exactly when their pet will mature or what it will look like when it gets there. You can use a multi-session intervention to help engage your client and get them excited to come to their next appointment.

Once the pets are grown, you can dress them up. Some options on the site cost money, but there are free options as well. I do not use money in this activity, which sometimes creates an opportunity for my client to have to accept when something they wanted to choose is not an option.

As I am writing this post, there is a free pack of disability accessories that you can get for your pets, including canes, hearing aids, and fidget toys. They recently had a free pack of Pride accessories. These little touches make this activity extra inclusive to your clients.

What will you and your clients create with virtual pet adoption?

4 Ways A Major Life Transition Can Help You Build Good Habits

Thank you again to Julie Morris for another guest blog! Today she shares tips for building habits during life transitions.

Image via Pexels

When a major transition occurs in your life, it can feel like a fresh start. Perhaps you’re moving to a new city, starting a new relationship, or simply making the decision to open up the next chapter of your life. Any of these situations can be taken as a chance to reset and take stock of all the good and bad in your life. It can be the perfect opportunity to build habits that will change your life for the better. Once you have an idea of some good habits you want to build, you can start removing the bad ones from your life entirely. 

1. Seeking a Career Change

Your job can be such an ingrained part of your routine that you might not notice if it becomes a source of stress. Your work might not feel challenging or fulfilling anymore, or perhaps you just feel stagnant. In any case, switching careers can greatly benefit your mental health.

If you would like to break into a totally different career field, you can accomplish that by enrolling in a flexible online degree program that will equip you with new skills while allowing you to continue working full-time. There are a huge number of online schools to choose from, so make sure you find one that is accredited and affordable.

2. Starting Your Own Business

As an alternative to switching careers, you might decide that it’s time to become your own boss. You can get started with your own venture by leveraging your passions and choosing the right business structure for your situation. Forming an LLC, for example, might be the right choice if you want tax advantages and protection from certain liabilities. Using a formation service makes it easy to meet state regulations without the complexities of filing yourself or hiring an expensive lawyer.

Keep in mind that marketing your business is important from day one, and all great marketing endeavors start with an appealing logo. If you’re on a budget, use an online logo maker to create attractive imagery with your choice of pre-existing style, icons, and fonts. And if you’re in a rush to get an image out quickly, there are tools that let you design a logo online quickly — and for free.

3. Eliminating Toxic Relationships

When you enter a new phase of your life, you might have to decide what to take with you and what to leave behind. If you have any toxic relationships sapping your mental energy, it is best to cut them off when the opportunity presents itself. However, it can be difficult to confront a toxic relationship without the mental health support you need in order to overcome it. Get all the help you need from your genuine friends and from licensed professionals so that you can move on to happier times. 

4. Reconnecting With Friends and Family

Psychologists explain that connections with friends and family are a form of social support that boost psychological well-being. Even if a busy lifestyle or a silly feud has led to you falling out of touch with your loved ones, it is never too late to reconnect. Let your latest life transition mark the turning point where you start sharing your happiness with the people who matter most and allow them to support you in turn.

Habits are hard to build and even harder to break. Even if you recognize that you’re letting stress into your life, finding the strength and motivation to make a change is not easy. That is why it’s important to let your big life transition be a catalyst that causes a chain reaction of positive changes that will improve your life going forward.

Resiliency Mental Health offers mental health resources and support to assist those who provide care for others. from parents and teachers to therapists and counselors. Learn more by clicking here.

It’s About To Get Slightly Less Unprofessional

Everybody get excited! There’s a new coloring book in town (sort of). From the brilliant minds who brought you It’s About To Get Real Unprofessional comes It’s About To Get Slightly Less Unprofessional!

It’s About To Get Slightly Less Unprofessional

What is It’s About To Get Slightly Less Unprofessional, you ask? Well, it’s the exact same book as It’s About To Get Real Unprofessional, but the curse words have been edited out! It was brought to our attention that some might prefer their self-care minus the F-bombs, and we are nothing if not accommodating (read: willing to re-release the exact same product with small modifications in order to boost our sales).

It’s About To Get Slightly Less Unprofessional features 68 of the coloring pages you remember and love with profanity bleeped out. Now you can color in public or around your kids without showing anyone any profanity!

Buy the hard copy on Amazon and the printable, PDF version on Etsy!

Do you already have It’s About To Get Real Unprofessional? Are you intrigued by It’s About To Get Slightly Less Unprofessional but you don’t want to buy a book that’s 50% a book you already own? Order It’s About To Get [Redacted], with JUST the censored pages! Available on Etsy as a printable or in paperback via Amazon!

Interview with Katy Lees, Therapist & Author

I connected with Katy Lees through Twitter because the internet is a wonderful place that keeps introducing me to fantastic people. Katy is the author of The Trans Guide to Mental Health and Well-Being, a comprehensive resource for trans folks and the people who care about them. Information about purchasing their book is available at the link above.

Katy was kind enough to take questions from me about their book as well as their work as a therapist for LGBTQ+ folks.

Katy Lees with their book

1. First can you tell me a little bit about your background and professional interests?

I’m a person-centred psychotherapist, with a BSc in Psychology and an MSc in Person-Centred and Experiential Psychotherapy. I’ve been working in mental health for nearly fifteen years now, and I’ve been working in private practice as a therapist for three years. I’ve also written fiction and non-fiction for several publications since my early twenties, perhaps most notably for the now sadly defunct Dirge Magazine.

2. Do see therapy clients? Tell me about your practice?

I run a thriving private therapy practice online which centres LGBTQ+ experiences. I mostly see trans and/or non-binary clients, many of whom are otherwise queer, polyamorous, neurodivergent, and dealing with trauma. Working with trans clients as a niche happened mostly by accident – I’m open about being non-binary and using they/them pronouns, and I think this led to lots of trans and/or non-binary people finding me! It’s such an honour to work with my community, whether it’s to help clients who are questioning their gender, clients who need help to process their feelings as they transition, clients who need support as they face transphobia, or trans and/or non-binary clients with any other issues.

3. Tell me about your book?

The Trans Guide to Mental Health and Well-Being is a book about self-care and community care, designed for trans and/or non-binary people. It’s a practical guide for taking good care of yourself, and it covers a wide range of mental health issues that trans people commonly face, including anxiety, depression, body image issues, trauma, suicidal thoughts, and dissociation. I designed the book to be something like a warm, accessible, expert therapist who can sit on your book shelf, ready for when you need them!

4. How did The Trans Guide to Mental Health and Well-Being come to be?

I’d been thinking about writing something like this for a while, especially after looking for some trans-specific mental health help during my MSc and not really finding much. After writing and speaking about my work in mental health and my transness for a while, I started writing the book in 2020 after being approached by my publishers, Jessica Kingsley Publishers. I finished writing the book in 2021, and it was officially published in 2022. You can now buy a copy wherever sells good books!

Katy Lee head shot

5. What do you want your readers and potential readers to know about your book?

This book was made to be a resource for trans and/or non-binary people, by a trans and non-binary therapist. It’s there for you if you need a few self-care tips or a bit of a pick-me; if there’s a specific issue or two that you’d like some in-depth help with; or if you’re in crisis. The book can be read from front to back or dipped in to when you need it. – Even though the book was written by and for the trans community, I think it can also be used by therapists, mental health professionals, and allies of trans and/or non-binary people who want to take a look at what some people in the trans community might be going through.

6. Do you have any other upcoming projects?

I’ve had a few conversations with my publisher about writing another book, so stay tuned!

CareDash Therapist “Directory”

Therapists, if you are not already aware, there is a website called CareDash that has created unauthorized profiles of thousands of mental health providers. The information posted is often inaccurate, and most colleagues I have spoken with were not aware that they were featured on the site before I told them.

My own profile lists me as an unlicensed, masters-level clinician in Massachusetts. I have not practiced in Massachusetts since 2013. It indicates that I specialize in anger management, eating disorders, and infidelity, none of which falls under my scope of practice. It also apparently lists me as a life coach.

Screen shot stating that my expertise includes Spirituality and Religion, Eating Disorder, and Life Coaching

Not only is the information about my practice inaccurate, but there is an option to request an appointment with me. This link does not lead to my practice – it leads to Better Help’s website. So, CareDash is pulling a bait-and-switch, using my name and reputation to funnel traffic to Better Help.

Let’s unpack everything that is wrong with this.

  1. A client seeking treatment is going to get inaccurate information about my practice. If they manage to get directed to me, they will waste valuable time and energy seeking services that I do not offer. This creates more steps and barriers in connecting them to the provider who can actually help them.
  2. This creates an administrative burden on me, since I have to then find an appropriate referral for the client, taking time and energy away from my other clients.
  3. A client seeking treatment who might actually benefit from my services could easily be routed to a different provider who is not a good fit for their needs. Clients seeking me out specifically are getting routed to Better Help instead of my practice.
  4. CareDash and Better Help are falsely marketing my services to get traffic and referrals for themselves.
  5. Since CareDash is misrepresenting my credentials, I am ethically “on the hook” for being falsely represented, per my ethics code.

CareDash’s website states that they will not take directory listings down because the information posted is through the NPI database and therefore “freely available.” Regarding complaints about misrepresentation, they state that you can “claim” your profile and update it. However, they will still use your name and accurate credentials to promote Better Help’s services.

I for one will not “claim” a directory listing on a website with unethical practices because doing so implies that I condone that directory.

I have reached out to CareDash demanding that they remove my profile but do not anticipate that they will comply. I have also reached out to my licensing boards to make them aware of the situation, let them know that I have taken steps to correct the ethical problem of misrepresenting my credentials, and to ask them to reach out to other psychologists to let them know that they might also be misrepresented on CareDash.

A PDF of my letter is below. I welcome any professional misrepresented on CareDash’s “directory” to use it as a template in contacting their own licensing board. I would hate for someone to have to waste time responding to a board complaint about misrepresentation they did not consent to or did not know was happening.

I also strongly encourage therapists to see if they are listed on CareDash. If you are, contact them demanding that your listing be taken down. My hope is that, with enough pressure, we can force their hand on ending this unethical and illegal “directory.”

Edit to Add

My friend and colleague, Stefani Goerlich, LMSW, put together a Google document for specific steps therapists can take when they find these fraudulent directory pages! This is not specific to CareDash and can be used with any website that surfaces with inaccurate information about your practice.

The document that Stefani put together is available here. Thank you, Stefani, for sharing!