Sunday, 14 September 2014

Our Shrinking World

It used to be that most people lived in small rural communities and doing so we had few secrets from others in our hometown or village.  We shopped at local stores, so our buying habits became known to our neighbours; we shared the philosophies we held dear to our hearts and they quickly became well known and judged or accepted by our peers, and any poor choice we made was broadcast to everyone we knew in short order.  If we made an unfortunate choice or committed a crime against another, we were easily identified and the consequences were unavoidable.

As we migrated away from our hometowns and villages into large metropolises, we quickly adapted and enjoyed the anonymity of blending in with the faceless crowd.  We could experiment with lifestyle choices; purchase what we wanted without judgment, and could keep secrets from our friends and family.  We were free spirits in a vast, disconnected world.  We found that we could get away with bad behaviour and avoid consequences for our crimes

Now, however, it appears that our world is shrinking back down to the the form of a village, not so much in population or geographic footprint, but in connectivity.  Recent news items highlight this trend;

The man who bullied and blackmailed Amanda Todd in British Columbia, Canada, driving her to complete her suicide, was a resident of the Netherlands.  He thought he was anonymous.  In April, 2014 he was arrested by Dutch authorities and charged with extortion, internet luring, criminal harassment and the possession and distribution of child pornography for his alleged activities against Amanda.

Just this past week, the identity of the masked ISIL executioner who filmed himself beheading two captured non-combat Americans, became known and shared amongst intelligence agencies of various countries responding to the ISIL threat.  There is no doubt that this man will be captured and brought to trial for murder or killed by anti-ISIL forces.

A third, non-criminal case arose recently when the father of a teen girl took Target stores to task for sending his daughter coupons for cribs, baby clothes and formula.  When Target investigated, they discovered that the algorithm their computers use to analyze purchases by their customers had noticed that the teen’s purchasing patterns had changed from that of a teen girl to an expectant future mother so it automatically began sending her ads and coupons that aligned with her new purchasing pattern.  And yes, the computer was correct - the girl confessed to her Dad that she was pregnant.

The internet is connecting us in ways we never intended.  We share our worldview on a social media site with our chosen friends who then share it with theirs and so on until the news of our politics or philosophies or opinions may be known to millions.  We are more aware of our world by receiving raw news feeds from all corners of the globe before it is filtered by the large media giants, yet at the same time we are part of that connectivity and news feed.

For better or worse, our vast anonymous world is shrinking to that of a global village which affords us community but gives us nowhere to hide.

Aaron D. McClelland, MMT, RPC -

Saturday, 8 March 2014

Suicide Season

I received a phone call today on the cell phone I use for my private practice.  It was a woman, slurring her words, groggy, somewhat confused.

She told me her name and I had to have her repeat it three times before I could understand her.  She asked for someone I’d never heard of then asked if she’d ever called me before.

I said she hadn’t, and asked her what was wrong (it was obvious something was).

“I’ve taken a lot of pills.” she said, “I need some help.”

I tried to get her address and to have her call 911 for help, but she hung up.

I immediately called 911 myself and reported the conversation and gave them the number she had called from - it was a cell phone number and the call taker didn’t know how to locate the woman.

But within two minutes of making the report, I received a call from an RCMP Constable who wanted to know if I had any further information about the woman - I didn’t.  He said that they had tracked the cell number to a residence and that it was registered in her name.  While we were talking, he said that the paramedics had rolled up at the address and he was less than a minute away.

I was proud that our local RCMP and Paramedics responded so quickly and efficiently to intervene in a suicide.

This encounter put me in mind that we are rapidly approaching Suicide Season.

Popular belief is that suicide rates are higher in winter months, but the reality is that spring and early summer have the highest rates of attempted and completed suicides.

The Center for Disease Control and Prevention indicate that suicide rates are lowest during the winter months and highest in the summer and spring, findings that have been corroborated by numerous studies, (Benedito-Silva et al, 2007; Bridges et al, 2005; Bazas et al. 1979).

Many psychologists suggest that spring is a symbolic time of renewal and change, and for those who struggle with depression, when there is no renewal or change, they lose hope.  Others suggest that after the deep depression of cloudy and cold winter months, the advent of more sunshine provides the depressed person more energy to plan and complete the complex task of suicide.

Whatever the reasons, we are about to enter the annual Suicide Season.  For men, spring is the most lethal season, while women have two peak times each year; spring and then again in autumn.

Canada ranks 40th overall worldwide for the number of suicides per capita, with 11.1 completed suicides per 100,000 people.   Greenland has the highest rate at 83 per 100,000, and Nepal the lowest at zero.

But the Canadian statistics hide an ongoing tragedy; Nanuvit’s completed suicide rate per 100,000 people is a staggering 71.  Which means if Nanuvit was a separate country it would be ranked number two over-all worldwide.

Age also stands out in statistics gathered about suicides; Men’s suicide rates peak in their 40s and again in their 90s; Women’s suicide rates peak in their 50s.

In Canada, suicide is the highest cause of violent death amongst adolescents.

What does all this mean for the average person?  Be aware of the warning signs;

  • Talking about wanting to die or to kill themself.
  • Looking for a way to kill themself, such as searching online or buying a gun.
  • Talking about feeling hopeless or having no reason to live.
  • Talking about feeling trapped or in unbearable pain.
  • Talking about being a burden to others.
  • Increasing the use of alcohol or drugs.
  • Acting anxious or agitated; behaving recklessly.
  • Sleeping too little or too much.
  • Withdrawn or feeling isolated.
  • Showing rage or talking about seeking revenge.
  • Displaying extreme mood swings.

And there is one sign that is difficult to spot; when a depressed person suddenly seems happy or content, visits friends and family, appearing to want to connect … or to say goodbye.  These may be the signs of someone who has made the decision to kill themself and is at peace with that decision.

If you suspect someone is suicidal, don’t be afraid to talk to them about it.  Don’t dance around the topic - if you suspect, ask them outright if they are thinking about killing themselves.  Listen to their reasons, empathize without arguing.  Tell them that you care about them and want to help them find relief from the emotions driving them to want to die.  Guilt and shame about leaving loved ones behind, or breaking a religious belief do not work - it only makes them feel worse.

Most important of all, don’t hesitate to contact their family members, or Doctor, or even the Police.  They may be angry that you interfered with their suicide plan.  But it’s better to have an angry family member or friend than a dead one.

Aaron D. McClelland, MMT, RPC -

Wednesday, 29 January 2014

Degree or Competence?

There is an ongoing struggle between degree-based associations and competency-based associations in the mental health field in Canada that may affect you or someone you know.  It's all about who YOU get to choose to seek counselling or psychotherapy from and the organizations that are trying to limit that choice.

Here is the basic argument;

Degree-Based Argument
The degree-based supporters, after completing four to six years of higher education and accumulated crippling student debt, and having achieved their Masters degree in whatever area they majored in, believe that education alone should be the only criteria for being allowed to practice counselling or psychotherapy in Canada.

Competency-Based Argument
The competency-based supporters, after accumulating enough training specific to counselling and psychotherapy, having achieved a suitable degree and putting in a sizable amount of time under direct clinical supervision, believe that their specific training and field experience qualifies them to practice psychotherapy.

I support the latter camp, and here is why;

Degree-Based Education
A typical Masters degree program with a major in counselling, normally requires 18 semester hours in the major sought.  So one class hour per week for 18 weeks in counselling.  The remaining required hours will be spent in support courses such as statistics, communication, biology, chemistry, etc, and of course a final thesis.

Competency-Based Education
The accredited college from which I received my Diploma require 820 semester hours and 180 practicum hours prior to graduation.  There are no supporting courses offered; students are required to have language and research skills already in place before being accepted

Degree-Based Associations Requirements
Entry requirements for degree-based associations vary, but all require a Masters degree or better.  The thing is, that many of them do not require the major to be in psychology or counselling.  Many accept a Masters in education or social work.  And once you pass a Criminal Record Check, you are designated as a Registered Clinical Counsellor, or Certified Clinical Counsellor.

The big question here is: How does a Masters degree in education or social work ensure competence as a counsellor or psychotherapist?  How is a person deemed competent without any field experience?

Competency-Based Associations Requirements
The association I belong to - the Canadian Professional Counsellors Association (CPCA) requires that individuals have training or education in core competency areas;
  • Clinical assessment
  • Grief Counselling Skills
  • Communication, Conflict Resolution Skills
  • Human Development Theory
  • Couples and Family Counselling Skills
  • Psychodynamic Therapy
  • Gestalt Therapy
  • Person-Centered Rogerian Therapy
  • Working Knowledge of the DSM
Once an individual’s education and training are verified, they must pass a Qualifying Exam, undergo a Personality Test, pass a Criminal Record Check, and enter into their internship as a Registered Professional Counsellor Candidate.

A Candidate’s internship is comprised of two years of direct clinical supervision under a CPCA approved supervisor who possesses a minimum of eight years field experience.

Even when an individual achieves full membership, they are required to complete 12 approved education credits per year to remain a member in good standing.

What Matters is Competence
Don’t get me wrong; I’m not questioning the value of  traditional higher education.  I’m only saying that is all it is - an education.  It doesn’t automatically indicate competence.

I worked with at-risk and high-risk youth in intensive therapeutic residential resources for a number of years, and during that time I came across scores of people with Masters degrees and PhDs.  Some were competent individuals who looked at their degree as a foundation to build upon as they learned their field skills in counselling and psychotherapy.  But there were also some who were absolute train wrecks when it came to front line work with a very challenging youth population.

I recall encountering one proud degree holder who was extremely confident in her competency despite having just graduated (the ink wasn’t even dry on her parchment).  She lasted exactly 15 minutes on the floor working with our youth.

An Important Note
Competency-based and degree-based associations do have two very important things in common; both have ethical rules and standards of practice members must adhere to, and both strive to protect the public through Complaint & Discipline and Ethics Committees.

How This Affects YOU
The problem is that the public is being cheated as degree-based associations lobby governments and health insurance companies, selling their mandate of Masters ONLY for counselling and psychotherapy, thereby limiting who YOU can see for any emotional or mental health issue you may need help with.

You see, the degree-based associations want a monopoly.  They want to squeeze out competent counsellors and psychotherapists to maintain control over the field of mental health.  They want to take away YOUR choice.

After all, they have a mountain of student loan debt to pay off and a monopoly will help them do that.

The difference between degree-based associations and competency-based associations is that the competency model believes there is room for everyone so long as they have proven competency; that the public should be given a choice; that the playing field should be level for all to provide services to the public within their individual scope of practice.

Evidence of this can be found by looking at the membership rolls in the CPCA; every education level is represented, from Pastoral counsellors, Diploma holders, Bachelor and Masters degree holders, and even PhDs.  And each and every one of them has proven competency in their field of practice.

If this lobbying by the degree-based associations annoys you; if you want to ensure you have a choice to seek out a competent professional for counselling or psychotherapy; write to your health benefits provider or your employee assistance provider or your union; write to your provincial Minister of Health and let them all know that you value competency - Competency in your counsellor or psychotherapist, and competency in your ability to choose the right one for you.

Aaron D. McClelland, MMT, RPC -