Therapist Journal

Understanding The Complications Of Clinical Work

Throughout my bachelor’s in clinical and counseling psychology and even more so in my graduate program for mental health counseling it seemed that the Diagnostic and Statistical Manual of Mental Disorders (DSM) was the end all and be all when it comes to diagnoses. I am now in the process of going for licensure in the Commonwealth of Virginia. I have started my 3, 400 hour residency under the licensure supervision of Anthony Lea, LPC. In our supervision meetings we have started to go back through the DSM starting with the introduction into the manual (that I never recalled reading or discussing in my graduate program).

What lesson have I pulled out from this process so far? There is a section in the very first few paragraphs that calls clinicians to remember that the DSM is not a comprehensive dictionary of disorders. In the “Use of the Manual” section  it highlights that “The symptoms contained in the respective diagnostic criteria sets do not constitute comprehensive definitions of underlying disorders, which encompass cognitive, emotional, behavioral, and physiological processes that are far more complex than can be described in these brief summaries. Rather, they are intended to summarize characteristic syndromes of signs and symptoms that point to an underlying disorder with a characteristic developmental history, biological and environmental risk factors, neuropsychological and physiological correlates, and typical clinical course.”

The key word that stood out to me was to “summarize” and prior to that “do not constitute comprehensive definitions” meaning that there is information and disorders beyond the DSM that a clinician will encounter in practice. I personally found this to be a revelation because over the course of my first year at Blackwater Outdoor Experiences we have worked with individuals who have had mental health disorder symptomatology that has not fallen directly under the diagnostic criteria of the DSM such as Nonverbal Learning Disability, and Processing Disorder. These two disorders specifically have affected a good portion of the clients I have been working with; there have been significant differences in their neuropsychological abilities that have caused them to struggle in academic, social, vocational, and familial settings. In most cases it was these neurodevelopmental or neurocognitive disorders specifically that were significant underlying factors for the development of the clients’ social anxiety, depression, low self-esteem, and substance use disorder.

Needless to say; my job just started feeling a lot more technical.

One could say that reality set in. At the same time I believe that the processes that I learned as a graduate student and now as a clinician in the field have allowed me to gain a better understanding of exactly how to parse through the information my clients present in order to help identify effectively what is the underlying struggle for them. I invite my clients on a journey with me on a therapeutic investigation to gather the clinical evidence we need to correctly identify these underlying struggles. Human behavior comes in a variety of personalities, emotions, actions, communication styles, and coping skills. The challenge as a clinician is to be able to understand that variety and recognize when an individual is dealing with a regular life stressor, trauma, or have a mental disorder.

How do you figure that out? That’s a topic for another day.

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Blackwater Outdoor Experiences: 2016 Accomplishments

I have been working at Blackwater Outdoor Experiences as a Field Therapist for a little over a year at this point. What has been able to be accomplished since my last post about Blackwater Outdoor Experiences?

We have been able to have 7 successful 22 Day Therapeutic Wilderness Expeditions for the 2016 year. Throughout that time we launched social media accounts on Facebook, Twitter, Instagram, Pinterest, and LinkedIn. On Facebook we were able to launch a Social Support Network group for students and their families of our expeditions to get weekly motivational posts, ask questions, discuss with other group members, and have professional resources available to them. Most recently we were able to update our website not only in it’s appearance but in the amount of information that it offers those who visit it. You can now find information about our aftercare support, our 22 Day program, and some of the latest testimonials from students and family members. For mobile users, we even included the ability to dial our number just by clicking a link.

Through generous donations we have been able to get participant T-Shirts made so that our students can have a physical take away from their expedition beyond their journals and used gear. Our relationship has grown with Caron Treatment Centers in Pennsylvania has grown that they consider us their designated wilderness program. We have seen students of our expeditions continue on with their college studies and write essays about the lessons and experiences they took away from their expedition with us.

As treatment program we have connected with Virginia Commonwealth University’s COBE program and their RAMS in Recovery program including presenting at their Family Education Program earlier in the year. Our partnership with Longwood University researcher Dr. Catherine Franssen continues to gather more data on the effects wilderness programs have on the stress levels and stress hormones in students who go through our program.

New aftercare programming resources have been uncovered such as those from Inner Change, and Real Recovery. New potential financial assistance programs have been identified in an effort to supplement beyond scholarships from our companion Wilderness Alternatives, Inc. (WAI).

What does the future look like for Blackwater Outdoor Experiences?

We have another expedition coming up on January 15th, 2017 to kick off the New Year. We are looking for another full time Field Therapist, Field Guides for upcoming expeditions, and even an Inbound and Product Marketing Manager to help us continue to grow! These are the highlights of the 2016; will you be apart of this with us in 2017?