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Messages - xEnderx

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16
News Items / Re: Jaycee Lee Dugard
« on: September 08, 2009, 02:00:11 AM »
This guy is a case study in deviant behavior waiting to happen. Personally it breaks my heart that the 2 children he fathered were raised in such a damaged environment.

He's a sick bastard with very little redeeming social value. Makes me feel like throwing up to think that his incarceration is being funded by tax payer dollars. Not only did he destroy 3 lives in this case (not to mention his record with abduction and rape), but he is further burdening society by being imprisoned.

17
Quote from: "psy"
[
I don't doubt that.  But don't expect everybody to agree with you just because you have knowledge.

Certainly not.

Quote
So are any risky choices, such as smoking.  Do you view addiction as a disease?

Addiction causes measurable and lasting changes in brain chemistry and in extreme cases physical development. Depending on the drug, these changes can be extremely long lasting. In many cases cravings can be alleviated or assisted by medication. Medically assisted detox is something that is needed in cases of extreme alcoholism. Methadone is used as a long term medication for opiate addiction.
 
Since is has measureable side effects, clear progression of intensity, and can be treated medically (or at least medically assisted treatment) it fits with the disease model. I hope that answers the question clearly enough. If not let me know.

18
Quality of life is defined by an individuals ability to fulfil what are called "ADL's". This means getting up and going to work, taking part in society, having a reasonable range of emotions (happy, sad, joyful, angry, etc), and generally feeling that they have a "life worth living".


I've always found it amusing that the statistics of spontaneous remission and AA assisted remission are pretty similar. Thats no joke....but the question of "could they have done it without AA" is sort of a moot point from my perspective.

If someone FEELS that AA helps them, then it helps them. Much the same way that statistically speaking the modality of a psychotherapist (narrative systems analyst, humanistic, behaviorist, etc) has zero effect on whether or not a person increases their quality of life. The ONLY case this isn't consistent in is regarding Cognitive behavioral and Dialectical behavior therapies in the treatment of anxiety disorders.

Just because I personally feel that AA is idiotic doesn't mean I will steer a client away from 12 step if it is somethign they want to explore. When speaking of adults, nobody forces them into an AA meeting (except court) and nobody forces them to really "get anything" out of their experience there.

Now adolescents are a completely different story. I don't really have the training to address addiction in that demographic, but I wouldn't personally push for an abstinence based modality (including 12 step) simply because I feel that it is not an attainable goal for a 15 year old.

19
Psych Hospitals / Re: Are We Really OK With Electroshocking Toddlers?
« on: September 08, 2009, 01:34:45 AM »
Quote from: "try another castle"
Quote
I usually see at least 1 client per month undergoing ECT at one of the Kaiser facilities here in the Bay Area and frankly, it seems helpful much of the time.

Wait a minute. Kaiser was helpful? You're shitting me.

Everyone I know who has kaiser says it sucks big fat balls of shit.

When I say "helpful" I mean that after the ECT has reached what is called the "maintenance stage" the clients verbalize lowered primary behavioral symptoms (depression, anxiety, suicidal ideation, etc) in comparison to their state prior to beginning the treatments. In my experience ECT is administered in conjunction with high intensity psychotherapy and (in every case I've seen) psychiatric medications.


I've heard complaints, and I've heard many success stories. With an HMO as large as Kaiser you'll get plenty of both. Per normal though, the negative publicity is that which you see most intensely. There are vast numbers of Kaiser patients that receive satisfactory health care. The ones that don't scream bloody murder.

Think about it like this....McDonalds serves millions of happy customers every day, but EVERYONE knows the story of the lady that sued because her coffee was hot. Not a 100% accurate comparison, but I hope you see what I'm trying to get at.


I also work in a facility that has most beds contracted out to Kaiser referral so I see probably 100-120 clients in a 2 month period that are referred from a Kaiser psych department. Most of them feel they get satisfactory health care...some do not. <shrug>

:) Hope that clarifies things a bit.

20
Quote from: "psy"

And btw, AA is not christian at all.  Many of their teachings are in stark opposition to those in the bible, such as the teaching that a human being has free will and actions are choices.  


The 12 step modality evolved out of quasi temperance movement. It has christian roots, and while not technically christian in their practices, the root behavior is there....evidenced by the concept of fellowship and somewhat "blind" obedience to mantra's such as "we keep what we have by giving it away", "It works if you work it", etc etc.

Hope that clears things up....I want it to be understood that I really do know what I'm talking about some of the time when I post on this forum. These are literally life and death things that we talk about...esp in regards to addiction and recovery.


Edit: Let me also be clear in regards to my intention in this thread. I am not attacking the idea of offering an alternative to 12 steps, I am simply stating that creating documentation of the type should include suggestions and information that allows increased access to another treatment modality.

21
The important question Psy, is as follows....."How are you measuring the word success"


Now if you are talking about lifetime sobriety, you won't find a damn program on planet earth that has any meaningful success rate. However if you define it by giving people an increase (however slight) in their day to day quality of life, and the ability to participate in a community that supports the concept of sobriety SOME 12 step communities can be very efficacious.


This does not mean I personally support the modality. It does mean that I understand the applicability of a faith based self help program in regards to certain populations. If you are polling a client from a culture that has shame or obligation based traditional rules (like Asian), or a culture that does not support open group discussion of patriarchal weakness (Latino), then you will have a lower rate of compliance (in the clinical sense).

Am I making sense?

I'm familiar with the "cult" mentality of the 12 step community, like I said....its derived from a christian root organization called "The Oxford Group" so do you honestly think that it can shed those roots? No. The organization cannot, nor should they rid themselves of that which forms the basis of their ideology.

The axiom most pertinent to this topic is "Some things work for some people some of the time". Thats a truism in the behavioral health and recovery professions. 12 step works for many people to some degree or another.

22
Psych Hospitals / Re: Are We Really OK With Electroshocking Toddlers?
« on: September 08, 2009, 01:12:57 AM »
I suggest that you familiarize yourself with the difference between medically administered MODERN ECT and what is generally conceived of when someone says "electroshock therapy". They aren't the same.

I usually see at least 1 client per month undergoing ECT at one of the Kaiser facilities here in the Bay Area and frankly, it seems helpful much of the time.


A very breif education for those unfamiliar with the procedure.

Under intense medical supervision the patient is sedated into a coma-like state, and while under this effect electrodes are placed on either temple. A jolt is then applied that "reboots" the brain, and this process releases chemicals that have proven to be effective in treating extreme depression that does not respond to medication or traditional therapy. I've also seen it used to assist in treatment of suicidal ideation, self mutilation, and other obsessive disorders. Generally this procedure is administered during a stay in a Crisis Residential facility so that the patient can be monitored for their own safety. It can cause some short term memory issues (12 hour timeframe) and some disorientation for a few hours.

As for it being applied to children, from what I have seen it would need to be an EXTREME case and honestly I don't think it would really be ethically sound due to developmental concerns.

Personally I don't have one problem with ECT in an adult patient population.

23
I'll let you in on a dirty secret.

Courts mandate AA/NA attendance because its a free treatment modality that has a track record of having a moderate success rate at increasing the quality of life for folks. On the flip side of the coin, statistically speaking, the pressure from court mandated recovery or pressure related to losing your job shows higher sustained sobriety rates than "walk ins".

Of course statistical studies of 12 Step "lifetime" sobriety also prove quite nicely how unobtainable the abstinence based models REALLY are, but hey....if it keeps the syringe out of your arm for 1 more day to say the Serinity Prayer, why knock it?

24
CAN ~ Collective Action Network / Re: Program Parents: Types and Psyches
« on: September 07, 2009, 11:23:09 PM »
Quote
TRICKED-- parents whose kids go to a program voluntarily. Entire family involved thinks they are going to some treatment center/school. When their kids say they are being mistreated they respond responsibly. They notice and respond to obvious warning signs


I think that one thing in this group that needs to be kept in the primary train of thought is the desperation and fear of said demographic. Parents that become afraid of the negative behaviors expressed by children become easy prey for anyone offering "salvation", "a cure", "help", etc regardless of the credentials of those offering the service. Also keep in mind that many of these programs can say "20+ years experience helping troubled teens" by virtue of their existence and graduation of kids each year.

Examine the fear and promote education for this group of parents because frankly, most of the other groups you mentioned are too damaged in their own rights to really be expected to react in a healthy manner to "troubled" teens.

25
While I support opposition to troubled teen gulags and such, I fail to see how the demonization of the 12 step modality is going to accomplish much of anything. Perhaps I am just not reading the thread closely enough? The purpose of these fliers is what exactly?

1. What message do you want to relay?
2. What positive ideology can you include to help facilitate communication?

Blasting an idea, or a modality, or a program simply by pointing out the negatives does nothing to truely address the situation. Offer an alternative.

In the case of 12 step opposition, I would personally suggest looking into "Smart Recovery" or "Life-Ring".

.02




Edit: Remember that 12 step communities are like any community. There are good ones and bad ones. Many 12 step groups are nothing but meat markets for folks with a damaged past, however MANY 12 step communities help both their members and the communities that they reside in.

Are you talking about adults or adolescents?

Many of the "cult" aspects of NA and AA involve psychological devices that replace habitual and ritualized perperation, lifestyle, and consumption of drugs with a lifestyle that is "addicted" to the concepts of sobriety and the concept of maintaining sobriety through reaching out to others.

Not that I support AA and NA, I personally find their bluntly christian overtones to be a turn off...but to deny that the modality has increased basic quality of life for many members is simply untrue.

26
Peninsula Village / Re: Getting Records From PV - URGENT
« on: September 07, 2009, 06:32:33 PM »
Email received while on vacation.

[qoute]Hello Mr XXXXX, I received your email this morning but did not receive the release forms I sent you. Your email indicated you had attachments but they were not there. I will wait on those to request your chart from our off site storage provider. I would be able to count the pages at that time. Again if you have any questions you may call me at the number below. Thanks.

 

Debra Montooth

 

Peninsula Village Medical Records

PO Box 100, Jones Bend Rd

Louisville, TN 37777

 

865-970-3255, option 1, option 2

1-800-255-8336, optionn 1, option 2

fax: 865-970-1812[/quote]



So it looks like you can find out in advance how copious their record keeping is. My next psych appointment is on the 17th of this month, so I'll be attempting to have the records released to my therapist once that time is reached. Either way, this should give folks a better grasp of the ease (or lack of ease) involved in obtaining records.

27
The Troubled Teen Industry / Troubled Teen program med regimens.
« on: September 03, 2009, 06:40:05 PM »
The following was written with Peninsula Village in Blount County TN in mind, however the fundamentals of this post apply to ALL troubled teen programs.

I think there should be a thread for people (parent's and alumni) to speak regarding the dosage and frequency of medications. I recall some VERY shady medication issues when I was a patient. Obscenely high dose, changing meds every week or so, etc. My issue is that rapid change of psychiatric medications, esp in adolescents, can cause real damage....in addition to being non-effective in treating the symptoms that are causing the primary behavioral health concern. In order to accurately report, anyone that has obtained their treatment records from PV can simply look at the medication logs. Recounting of what was seen from parent and client perspective would be useful as well.

I recall hearing someone state that PV had them on 120 mg of Abilify per day, and I seem to recall hearing about 800+ mg of Seroquel. This correlates to the time period in which parents have reported rapid or extreme weight gain in their kids. Both of these meds are known to have significant side effects if over prescribed. Hell, the biggest red flag of anti-psychotic over prescription is weight gain.

As a point of reference for the previously mentioned medications. 800+ mg of seroquel is approved for the treatment of highly psychotic schizophrenic or (in rare cases schizo affective) ADULT patient. I don't think 120 mg Abilify is approved in any population. Adolescents do not metabolize the same way that adults do, and thus have far different needs in regards to therapeutic medication doses.



Anyway, you get the point. Thanks in advance.











P.S. If you are the parent of a child that is being prescribed psych meds, PLEASE do some research on the history and side effects of the med in question. Being an informed parent is the first step in being a responsible parent. Don't take it on faith that "the doctor knows best". It is also a good idea to know what psychiatric terms such as "schizoid, psychotic, disorder, therapeutic, etc" really mean. Many times these terms are used improperly, or for effect. The end result of this is that misinformed parents are frightened or bullied such that they give in to the demands or recommendations of less than ethical "professional" staff. If you want what is best for your child, you need to understand the most basic aspects of adolescent psychiatry.

28
Peninsula Village / PV and medication dose/regimen.
« on: September 03, 2009, 06:23:39 PM »
The following was written with Peninsula Village in Blount County TN in mind, however the fundamentals of this post apply to ALL troubled teen programs.

I think there should be a thread for people (parent's and alumni) to speak regarding the dosage and frequency of medications. I recall some VERY shady medication issues when I was a patient. Obscenely high dose, changing meds every week or so, etc. My issue is that rapid change of psychiatric medications, esp in adolescents, can cause real damage....in addition to being non-effective in treating the symptoms that are causing the primary behavioral health concern. In order to accurately report, anyone that has obtained their treatment records from PV can simply look at the medication logs. Recounting of what was seen from parent and client perspective would be useful as well.

I recall hearing someone state that PV had them on 120 mg of Abilify per day, and I seem to recall hearing about 800+ mg of Seroquel. This correlates to the time period in which parents have reported rapid or extreme weight gain in their kids. Both of these meds are known to have significant side effects if over prescribed. Hell, the biggest red flag of anti-psychotic over prescription is weight gain.

As a point of reference for the previously mentioned medications. 800+ mg of seroquel is approved for the treatment of highly psychotic schizophrenic or (in rare cases schizo affective) ADULT patient. I don't think 120 mg Abilify is approved in any population. Adolescents do not metabolize the same way that adults do, and thus have far different needs in regards to therapeutic medication doses.



Anyway, you get the point. Thanks in advance.











P.S. If you are the parent of a child that is being prescribed psych meds, PLEASE do some research on the history and side effects of the med in question. Being an informed parent is the first step in being a responsible parent. Don't take it on faith that "the doctor knows best". It is also a good idea to know what psychiatric terms such as "schizoid, psychotic, disorder, therapeutic, etc" really mean. Many times these terms are used improperly, or for effect. The end result of this is that misinformed parents are frightened or bullied such that they give in to the demands or recommendations of less than ethical "professional" staff. If you want what is best for your child, you need to understand the most basic aspects of adolescent psychiatry.

29
Peninsula Village / Re: Getting Records From PV - URGENT
« on: September 03, 2009, 03:44:56 AM »
Bear in mind that notes written by different people about the same situation may be different if they are not properly trained in how to write an objective behavioral progress note. Given the lack of required experience or credentials for line staff, I highly doubt that all of them are capable of writing a quality progress note. That alone is reason enough for a parent to have second thoughts about sending their child to this facility. Abuse and all the horror stories aside, if the staff that is responsible for the day to day care of the patients can't even write an objective note do you really think they are going to provide the level of care you'd expect to receive for the outrageous PV cost?

30
Peninsula Village / Re: Getting Records From PV - URGENT
« on: September 01, 2009, 09:44:57 PM »
Judging by the amount of documentation that msot facilities I work with in California are required to do, I think that 300 pages would cover a stay of MAYBE 2 months. Thats a pretty conservative estimate.

You are going to have a minimum of 1 page per progress note per shift, per day. Plus at least 1 group note per day. Plus a page any time the patient is restrained. Thats not counting documentation for medication changes, treatment team meetings, family meetings, etc.

Keep in mind though, I don't have any hard numbers as far as how many pages are included in my personal packet. Once I find out, I'll post it up here. Luckily I'm in a position that I can get a HIPPA release signed by either my clinician or my personal therapist. The "professional courtesy" part of the email is something that I will work on getting details about. Might be a loophole that folks can use to get their records without draining their bank accounts.

I'd say that the crazy charge scale for records is clearly a tactic to keep people from following through on getting them.

Just to put things in perspective the facility I work for generally ends up with 120+ pages of documentation for our clients. We are designated as a 5-7 day facility.

Edit: Nice to see that the PV staff can't even be bothered to use a spell checker.

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