David's Therapy: Clinical Questions Blog

PsychEd Podcast

dcesarini@gmail.com (David Cesarini) — Wed, 22 Feb 2023 20:02:21 GMT

For medical learners by medical learners

PsychEd is an educational psychiatry podcast written and produced by psychiatry residents at the University of Toronto and is aimed at medical students and residents. Listeners learn about topics in psychiatry as the resident team explores the subject with world-class psychiatrists.

Listen to the PsychEd Podcast here

Black History Month

dcesarini@gmail.com (David Cesarini) — Sat, 04 Feb 2023 14:43:18 GMT

Therapy for Black Girls Podcast

When I'm looking for podcasts for clients, I usually focus on specific episodes that are relevant to the problem-situation at hand and a response or intervention to match. Often the client or I will discuss their use of journaling, grounding techniques or financial strategies. Listed below are episodes related to each topic.

Mental Health Apps List

dcesarini@gmail.com (David Cesarini) — Sun, 29 Jan 2023 18:03:32 GMT

A selection of apps that have been tested and reviewed

Several websites offer clinician-based reviews of mental health apps, including One Mind PsyberGuide and Very Well Mind .

Cognitive Behavioural Therapy - CBT

Depression

Anxiety

Anger

AIMS

Mood Tracker

Sleep

Sleep Diary

Free Online programs

New Low Risk Drinking Guidelines

dcesarini@gmail.com (David Cesarini) — Sat, 21 Jan 2023 19:52:52 GMT

One to two drinks per week only for low risk drinking

CCSA updated Canada's guidance on alcohol and health with new low risk guidelines .

The new guidelines define 1-2 drinks per week for both men and women as low risk for developing several types of cancer, heart disease and stroke. Beyond the 1-2 drinks per week range, their research indicates that over time you are at increasing risk of developing cancers, heart disease and stroke.

The new guidelines are a significant change from previous low risk guidelines ( 2018 ), which defined low-risk as less than 15 drinks per week for men and less than 10 drinks per week for women.

Speaking of Psychology Podcast Episodes

dcesarini@gmail.com (David Cesarini) — Sun, 08 Jan 2023 15:28:05 GMT

American Psychological Association podcast provides helpful information on a variety of mental health topics

Over the past several months, I managed to collect and review many of the Speaking of Psychology podcast episodes. I have found a significant uptick in requests for podcast episodes from clients, and have listed the most relevant episodes, below :

Crazy Ex-Girlfriend violates boundaries, stumbles into self-discovery

dcesarini@gmail.com (David Cesarini) — Tue, 25 Sep 2018 01:01:09 GMT

What does a musical that’s all about making mistakes, tell us about ourselves?

Crazy Ex-Girlfriend is show that embraces that rare combination of irreverence, fallibility and acceptance. But more importantly, the show bravely depicts the complexities and challenges of fostering and sustaining our own mental health .

The main character, Rebecca Bunch, sings and dances her way through some questionable life decisions and some serious negative consequences. But, in a way, she teaches us the process of change and adaptation we all might encounter from time-to-time. In so doing, she enhances our own empathy for mental illness and our mental health literacy .

Rebecca’s journey is faithful to the experience of many, and includes the depiction of a gradual restoring of balance that reflects the commonly experienced “ebbs and flows” of recovery. Rather than quick fixes, Rebecca eventually visits a counsellor, whose job is to engage and facilitate her treatment.

Counsellors trained in cognitive behavioural therapy and dialectical behaviour therapy work with clients like Rebecca to reflect upon, and challenge self-destructive thoughts and behaviour patterns and bolster resilience.

Antidepressant withdrawal complicates prescribing

dcesarini@gmail.com (David Cesarini) — Wed, 18 Jul 2018 02:08:00 GMT

Trend toward broader, longer use of antidepressants, compounds concern

An article in the New York Times lays out the case for concern: the doubling in use of prescription antidepressants since 2010, the trend toward longer-term use, along with the already recognized side-effects of anti-depressants, and now the rising reports of withdrawal effects.

Exercise for depression shows benefits

dcesarini@gmail.com (David Cesarini) — Tue, 17 Jul 2018 01:03:30 GMT

People that are depressed are sometimes suggested exercise as a treatment, but is it effective?

In a high grade meta-analysis, research results indicate that exercise results in small to moderate improvements in depression.

They examined the effect on scores rated using the Beck Depression Inventory (BDI). Using one technique to sort the data, the reduction in depression scores associated with exercise, compared to control, was equivalent to 5 BDI points. Using a more restrictive technique to gauge the effect, the results showed no association with improvements.

As noted in the research, current practice guidelines recommend structured exercise, 3 times a week for 10 to 14 weeks, for treatment of mild to moderate depression.

Bloom’s Taxonomy

Thu, 21 Dec 2017 02:04:00 GMT

Bloom’s taxonomy of educational objectives are a potential reference for curriculum development discussions.According to Bloom’s taxonomy, educational objectives can fall within three domains: cognitive, affective, and psychomotor learning.The cognitive domain includes six levels of learning development goals that range from introductory to mastery level. The six levels are: knowledge, comprehension, application, analysis, synthesis, evaluation. Listed within the knowledge level, for example, are verbs to help writing objectives in the cognitive domain, including: know, define, memorise, etc.So, if you’d like to introduce the learners to a topic within the cognitive learning domain, first you might write an objective at the knowledge level, “to define…”. If you’d like to reinforce that subject matter cognitively, you might pick a verb from the application of learning level, like “to demonstrate…”.The affective domain includes five levels of learning development goals, the psychomotor domain includes six.Since the taxonomy was introduced in 1956, there have been revisions.

According to Bloom’s taxonomy , educational objectives can fall within three domains: cognitive, affective, and psychomotor learning.

The cognitive domain includes six levels of learning development goals that range from introductory to mastery level. The six levels are: knowledge, comprehension, application, analysis, synthesis, evaluation. Listed within the knowledge level, for example, are verbs to help writing objectives in the cognitive domain, including: know, define, memorise , etc.

So, if you’d like to introduce the learners to a topic within the cognitive learning domain, first you might write an objective at the knowledge level, “to define…”. If you’d like to reinforce that subject matter cognitively, you might pick a verb from the application of learning level, like “to demonstrate…”.

The affective domain includes five levels of learning development goals, the psychomotor domain includes six.

Since the taxonomy was introduced in 1956, there have been revisions .

A Critical Examination of CBT in Clinical Social Work Practice

Mon, 12 Jun 2017 16:19:00 GMT

“Hot Cross Buns” photo taken by FraserElliot*In the June 2017 issue of Clinical Social Work Journal, Brian Rasmussen, reviews the dominance and weakness of Cognitive Behavioural Therapy (CBT).The review points out a number of pros and cons of CBT, and an especially compelling argument is made for clinicians to reflect on how they might learn, practice, and aim for, a contextually conscientious application of clinical social work interventions:Western cultural norms of hyper-individualism lay the ground-work for theories and treatments that locate mental health problems in the conscious, rational mind of the person, often decontextualize from his or her social surround.*”Hot cross buns” in CBT refers to the cross-sectional model of elements affecting our perception of a situation: thoughts, mood, action, and physiological sensations.

In the June 2017 issue of Clinical Social Work Journal , Brian Rasmussen, reviews the dominance and weakness of Cognitive Behavioural Therapy (CBT).

The review points out a number of pros and cons of CBT, and an especially compelling argument is made for clinicians to reflect on how they might learn, practice, and aim for, a contextually conscientious application of clinical social work interventions:

*” Hot cross buns ” in CBT refers to the cross-sectional model of elements affecting our perception of a situation: thoughts, mood, action, and physiological sensations.

Brief Intervention and Contact (BIC) to prevent suicide

Mon, 22 May 2017 01:05:00 GMT

Self-portrait with Bandaged Ear (1889) by Vincent Van Gogh (1853–1890)A meta-analysis of randomly controlled trials for strategies to prevent death by suicide revealed BIC was associated with significantly lower oddsof suicide than Cognitive Behavioural Therapy (CBT) or lithium .In low to medium income countries, the results indicate that the World Health Organization (WHO) BIC method had a statistically significant effect in reducing suicide. CBT or lithium treatments in the analysis yielded non-significant findings.BIC is more elaborately described in the precursor study, Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries:BIC is described as a 1-hour individual information session as close to the time of discharge as possible and, after discharge, nine follow-up contacts (phone calls or visits, as appropriate) according to a specific time-line up to 18 months (at 1, 2, 4, 7 and 11 week(s), and 4, 6,12 and 18 months), conducted by a person with clinical experience (e.g. doctor, nurse, psychologist).The individual information session was conducted according to a written protocol which all sites adhered to. It included information about suicidal behaviour as a sign of psychological and/or social distress, risk and protective factors, basic epidemiology, repetition, alternatives to suicidal behaviours, and referral options. Whenever an interviewer realized that a patient needed more intensive treatment, the relevant referral to help was made, when available and if judged necessary

A meta-analysis of randomly controlled trials for strategies to prevent death by suicide revealed BIC was associated with significantly lower odds
of suicide than Cognitive Behavioural Therapy (CBT) or lithium .

In low to medium income countries, the results indicate that the World Health Organization (WHO) BIC method had a statistically significant effect in reducing suicide. CBT or lithium treatments in the analysis yielded non-significant findings.

BIC is more elaborately described in the precursor study, Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries:

Men’s depression and suicide literacy in Canada

Sun, 08 Jan 2017 18:34:00 GMT

After 901 people completed the quiz below, the results indicated that generally Canadian men got less answers right about how to identify symptoms of depression and prevent suicide.The quiz calculated the difference between men and women in knowing the symptoms of depression (the correct answer is in brackets after each question):Men with depression often speak in a rambling and disjointed way. (False)Men with depression may feel guilty when they are not at fault. (True)Loss of confidence and poor self-esteem may be a symptom of men’s depression. (True)Men with depression often hear voices that are not there. (False)Sleeping too much or too little may be a sign of men’s depression. (True)Eating too much or losing interest in food may be a sign of men’s depression. (True)Depression does not affect men’s memory and concentration. (False)Having several distinct personalities may be a sign of men’s depression. (False)Most men with depression need to be hospitalized. (False)Many famous men have suffered from depression. (True)The suicide quiz questions (correct answers are in brackets):Men who have thoughts about suicide should not tell others about it. (False)Most men who suicide are psychotic. (False)Men talking about suicide always increase the risk of suicide. (False)Not all men who attempt suicide plan their attempt in advance. (True)Very few men have thoughts about suicide. (False)Men are more likely to die by suicide than women. (True)Men who want to attempt suicide can change their mind quickly. (True)There is strong relationship between men’s alcoholism and suicide. (True)Men's depression and suicide literacy: a nationally representative Canadian surveyOliffe, John L.; Hannan-Leith, Madeline N.; Ogrodniczuk, John S.; Black, Nick; Mackenzie, Corey S.; Lohan, Maria; Creighton, Genevieve. Men’s depression and suicide literacy: a nationally representative Canadian survey. Journal of Mental Health: Vol. 25 Issue 6 – 2016.

After 901 people completed the quiz below, the results indicated that generally Canadian men got less answers right about how to identify symptoms of depression and prevent suicide.

The quiz calculated the difference between men and women in knowing the symptoms of depression (the correct answer is in brackets after each question):

The suicide quiz questions (correct answers are in brackets):

Men's depression and suicide literacy: a nationally representative Canadian survey

Oliffe, John L.; Hannan-Leith, Madeline N.; Ogrodniczuk, John S.; Black, Nick; Mackenzie, Corey S.; Lohan, Maria; Creighton, Genevieve. Men’s depression and suicide literacy: a nationally representative Canadian survey . Journal of Mental Health: Vol. 25 Issue 6 – 2016.

Animal Assisted Therapy Recommended for Anti-Oppressive Social Work Practice

Fri, 06 Jan 2017 01:06:00 GMT

Animal Assisted Therapy Recommended for Anti-Oppressive Social Work Practice“…therapy doesn’t have to look like a desk, or, you know, an office. Therapy can be in a barn.”Some of the practice benefits of other-than-human animals: they are non-judgemental and accepting; they shift the binary power relationship between practitioner and service user; and the lived experience of rescue dogs mirrored the experience of people without shelter.The author cites a wide variety of therapeutic benefits of animal-assisted interventions on loneliness, socialising, motivation, physiology and mood.The Role of Animal-Assisted Interventions in Anti-Oppressive Social Work PracticeLegge, Melissa Marie. The Role of Animal-Assisted Interventions in Anti-Oppressive Social Work Practice. British Journal of Social Work: Vol. 46 Issue 7 – 2016

Animal Assisted Therapy Recommended for Anti-Oppressive Social Work Practice

“…therapy doesn’t have to look like a desk, or, you know, an office. Therapy can be in a barn.”

Some of the practice benefits of other-than-human animals: they are non-judgemental and accepting; they shift the binary power relationship between practitioner and service user; and the lived experience of rescue dogs mirrored the experience of people without shelter.

The author cites a wide variety of therapeutic benefits of animal-assisted interventions on loneliness, socialising, motivation, physiology and mood.

The Role of Animal-Assisted Interventions in Anti-Oppressive Social Work Practice

Legge, Melissa Marie. The Role of Animal-Assisted Interventions in Anti-Oppressive Social Work Practice . British Journal of Social Work: Vol. 46 Issue 7 – 2016

Attachment anxiety and anthropomorphism of pets and gadgets

Thu, 05 Jan 2017 18:25:00 GMT

The authors showed that attachment anxiety predicts the anthropomorphizing of pets and gadgets. The desire for closeness, fear of abandonment, and hyper-vigilance to social cues, more so than loneliness, predicted the likelihood that people would attribute human traits to non-human agents. The authors extended the research by showing that remembering a satisfying intimate relationship can reduce reliance on anthropomorphizing.http://pss.sagepub.com/lookup/doi/10.1177/0956797616668510Bartz, J. A.; Tchalova, K.; Fenerci, C. Reminders of Social Connection Can Attenuate Anthropomorphism: A Replication and Extension of Epley, Akalis, Waytz, and Cacioppo (2008) Psychological Science: Vol. 27 Issue 12 – 2016: 1644 – 1650

http://pss.sagepub.com/lookup/doi/10.1177/0956797616668510

Bartz, J. A.; Tchalova, K.; Fenerci, C. Reminders of Social Connection Can Attenuate Anthropomorphism: A Replication and Extension of Epley, Akalis, Waytz, and Cacioppo (2008) Psychological Science: Vol. 27 Issue 12 – 2016: 1644 – 1650