Celebrating National Autism Awareness Month

Here at TPN.Health, we are celebrating National Autism Awareness Month throughout the whole month of April, 2020. We celebrate those whom autism spectrum disorder (ASD) affects as well as the committed behavioral health practitioners, researchers, and teachers who specialize in the realm of ASD.

ASD is classified as a set of developmental disorders ranging in severity and symptoms and resulting from a variety of genetic and environmental factors. These include Kanner’ syndrome, Aspbergers’ syndrome, and pervasive developmental disorder not otherwise specified (PDD-NOS). It was only in 2013 that the definition of autism broadened to include those neighboring developmental disabilities in a spectrum format. 

Symptoms of ASD can include but are not limited to repetitive patterns of behaviors and interests, delayed development in childhood, difficulty adapting to change, and challenges in relating to other people verbally and nonverbally. ASD can also include tendencies toward truth-telling (even when it is not in one’s best interest), a preference for structure, and the ability to focus on one area of interest for a long period of time. Once again, these symptoms are by no means an exhaustive list, and each individual on the autism spectrum is unique with their own set of challenges and strengths.

Did you know…

Males are four times more likely to be diagnosed with autism than females.

Some studies suggest that females, who are considered “high-functioning” on the autism spectrum, are likely to conceal their symptoms and potentially go undiagnosed as a result. Also known as ‘camouflaging,’ the effort to conceal symptoms can surface as persistent mimicry of neurotypical behaviors, such as forcing oneself to make eye contact or rehearsing lines to say in conversation. Camouflaging can also surface as efforts to suppress Stereotypy, the repetitious behaviors associated with ASD symptoms. However, studies on camouflaging are limited, and more research in the field is needed to draw any conclusions.

From 1911 to 1943, Autism was associated with symptoms of schizophrenia. 

Eugen Bleuler, an influential Swiss psychiatrist, used “autos,” the Greek word for “self,” to create the term “autism.” He used the term to classify symptoms of self-absorption that he saw in schizophrenic patients. It wasn’t until 1943 that Austian-American psychiatrist Leo Kanner distinguished Autism from schizophrenia and defined it as a separate socio-emotional disorder.

Before the behavioral health community knew about the genetic component of autism, it was theorized that parental apathy brought on autism.

This belief took hold after Bruno Bettelheim, Austrian-American psychiatrist and early writer on autism, coined the term “Refrigerator Mother” in the 1950s to describe research on the relationship between delayed  childhood development and parental emotional neglect. With the popularization of this term, it became a common belief that parents with a cold, uncaring attitude toward their children were responsible for “causing” autism. It wasn’t until the late 1970s that researchers discovered the genetic component to autism. 

Need to refer out for a client who has symptoms of ASD? Click here to create a TPN.Health profile, and use the filter-search to find the best clinical fit!

References:

Asperger Profiles: The Big Picture – Strengths. (2016, September 21). Retrieved from https://www.aane.org/asperger-profile-strengths/

Correcting the record: Leo Kanner and the broad autism phenotype. (2018, April 5). Retrieved from https://www.spectrumnews.org/opinion/viewpoint/correcting-the-record-leo-kanner-and-t

Osborn, C. O. K. (2019, March 8). Understanding Autism in Women. Retrieved from https://www.healthline.com/health/autism-in-women#symptoms-in-women

Strengths and abilities in autism. (2018, September 17). Retrieved from https://www.altogetherautism.org.nz/strengths-and-abilities-in-autism/

The costs of camouflaging autism. (2020, February 7). Retrieved from https://www.spectrumnews.org/features/deep-dive/costs-camouflaging-autism/

The Editors of Encyclopaedia Britannica. (2020, February 6). Autism spectrum disorder. Retrieved from https://www.britannica.com/science/autism-spectrum-disorder

What is Autism Spectrum Disorder? (2019, September 23). Retrieved from https://www.cdc.gov/ncbddd/autism/facts.html

Image credit: https://penntoday.upenn.edu/news/how-companies-are-increasing-neurodiversity-workplace

Historical Figures in Behavioral Health: Springtime Edition

Happy Spring! A season of new growth, planting, and preparing for abundance awaits us. It is a good time to remember the work of those who planted seeds and tilled the soil in the field of behavioral health. So, to kick off the month, TPN.Health is recognizing a few April-born historical figures who have cultivated the field of behavioral health through their significant contributions in research, teaching, and activism. 

Abraham Maslow, PhD: April 1st, 1908 – June 8th, 1970

Arguably Maslow’s most well-known contribution to the field of behavioral health was his “Hierarchy of Needs,” which sprang from observations in his early work with monkeys. Rooted in human motivational studies, Maslow’s Hierarchy of Needs is arranged in five levels with basic needs at the bottom, psychological needs in the middle, and self fulfillment needs at the top. 

Having originally pursued philosophy and behaviorism (a prominent force in psychology at the time), he did not begin his work studying human motivation until the humbling experience raising a family during the collective upheaval of World War II prompted him to do so. Deviating greatly from the thought leaders of his time, who framed the human being in machine-like terms of reductionism, Maslow’s work in humanism, encompassing self-actualization and human motivation, served to integrate “personhood” into the field. His research laid the groundwork for developments in the field of personality psychology, which ultimately grew to shape the orientation of the behavioral health field as we know it today. 

Dorthea Dix, Mental Health Reformer: April 4th, 1802 – July 17, 1887

A teacher by trade, Dix’s journey in social reform began while teaching Sunday school at a women’s prison in Massachusetts. Immediately, she noticed the horrific conditions and particularly cruel treatment of those with mental health issues. Subsequently devoting her life to the reform of prisons, poorhouses, and mental institutions for better treatment of their inhabitants, Dix went on to lobby at the national and international levels. In the U.S. her efforts resulted in a federal grant for public land to be used in service of those with mental illness, a grant which President Franklin Pierce unfortunately vetoed several years after issuance. In Europe, Dix’s report to Pope Pius IX on the incongruity of public and private health facilities brought on the construction of a hospital, which was to benefit those with mental health issues.

Mamie Phipps Clark, PhD: April 18, 1917 – August 11, 1983

Clark was an active researcher, practitioner, and force in social activism in her time. Even up against the walls of sexism and racism in mid-twentieth-century America, Clark pioneered studies of the effects of internalized racism in black children in her master’s thesis and was the first African American woman to obtain her PhD in psychology from Columbia University. Her thesis contributed to structures underlying the field of developmental psychology and was instrumental in the creation of the first mass-produced doll with African-American representation.

In her time working at a private home for the refuge of young black females in New York, she noticed a serious deficit in mental health services for black children as well as rampant mis-diagnoses of the individuals in the facility. Upon the refusal of governing bodies to provide adequate services after Clark and her husband, Kenneth Clark, presented this issue, the Clarks elected to open what is now called the Northside Center for Child Development, which was the first institution to offer full-time psychological and social services to families in Harlem. Likewise, serving on a number of committees and advisory boards throughout her life, Clark maintained active involvement in her community and testified as an expert witness in the 1954 Brown vs. Board of Education case as well as other school desegregation cases.  

Three claps for these trailblazers in behavioral health history! Today, you can create a TPN.Health clinical profile to begin reaping the benefits of a trackable referral network and a trusted clinical community–all at your fingertips.

Click here to get started.

References:

Boeree, C. G. (n.d.). Retrieved from https://webspace.ship.edu/cgboer/maslow.html

Clark, Mamie Katherine Phipps. (n.d.). Retrieved from https://encyclopediaofarkansas.net/entries/mamie-katherine-phipps-clark-2938/

Dorothea Dix. (2019, April 12). Retrieved from https://www.biography.com/activist/dorothea-dix

Mamie Phipps Clark, PhD, and Kenneth Clark, PhD. (n.d.). Retrieved from https://www.apa.org/pi/oema/resources/ethnicity-health/psychologists/clark

Wood, A. G. (2000, February). Dix, Dorothea Lynde (1802-1887), social reformer. Retrieved from https://www.anb.org/view/10.1093/anb/9780198606697.001.0001/anb-9780198606697-e-1500181

Image Credits:

https://www.verywellmind.com/biography-of-abraham-maslow-1908-1970-2795524

http://www.teachushistory.org/node/385

https://ourselvesblack.com/journal/profiles-in-black-mamie-phipps-clark-1917-1983

https://www.verywellmind.com/what-is-maslows-hierarchy-of-needs-4136760

There’s More to “Just Google it” Than You Think

Does anyone remember a time when we did not have at-a-glance access to a screen that could tell us exactly what we want to know? A time when physically digging for hard copies, traveling to a destination, and relating to human beings were the only available pathways to get to information? Generation X-ers (and some Millennials), this is where you press your fingertips together and soberly nod your heads. 

Of course, unlimited access to the breadth and depth of information that is contained in the internet can only serve to make us smarter, more evolved human beings, right? Well, the answer is not so linear. The reality is that internet use can have certain unexpected effects as to how humans process information. 

Fisher, Goddu, and Keil (2015) explored the relationship between the internet and human transactive memory, socially dependent memory systems composed of encoding, storage, and retrieval of information across a group of people. Transactive memory systems are composed of two parts–internal, consisting of “what I know,” and external memory, which tracks what others know. For example, if a group of friends go on a road trip and the car breaks down (pretend there is no access to cell service, internet connection, or roadside assistance), the people in this situation would at some point begin to assess who knows what about cars and proceed accordingly. So, these social memory systems enable individuals to divide cognitive tasks among each other. 

Even though transactive memory systems are traditionally studied in application to the human social sphere, they can be similarly applied in a context where the internet serves as external memory. A body of research suggests that within this frame, retention of internal memory may be negatively impacted (Fisher 2015). Unlike typical transactive memory systems that rely on relationships, with the internet there is no mutual sharing of information and therefore no need for other relational nuances like negotiation and dividing of responsibility. As the internet asks nothing of people, and people rely on it as the one all-knowing expert, accountability for and tracking of one’s own internal memory decreases . 

A body of research shows that when there is an impediment to tracking internal memory, people can have a distorted sense of what they actually know. For instance, when people seek information from sources, like other people or libraries, the distinction of “what I know” and “what the other knows” is clear. However, this line becomes blurred with the overarching accessibility, immediacy, and reliability of the internet, and the result is that evaluations of “what I know” can become overinflated (Fisher 2015). In a similar way, people tend to be able to have increased ability to recall where they found information but decreased ability to recall the information itself (Sparrow, Lieu, & Wegner 2011).

As that the internet is and will continue to occupy the function of a primary transactive memory partner for humans, the workings of this “partnership” and how it affects those on the user end is a burgeoning field of study. Considering how deeply the internet is woven into our lives, increased exploration of how our minds and bodies interact with the internet is a necessary pursuit.

Click here to create a TPN.Health profile today. There is no better time to get access to quality continuing education opportunities, a trusted referral network, and opportunities to build relationships with this trusted clinical community.

References:

Fisher, M., Goddu, M. K., & Keil, F. C. (2015). Searching for explanations: How the Internet inflates estimates of internal knowledge. Journal of Experimental Psychology: General, 144(3), 674–687. doi: 10.1037/xge0000070

Sparrow, B., Liu, J., & Wegner, D. M. (2011). Google Effects on Memory: Cognitive Consequences of Having Information at Our Fingertips. Science, 333(6043), 776–778. doi: 10.1126/science.1207745

Image Credit: https://www.proprofs.com/c/lms/what-is-computer-based-assessment/

A Call To Examine Our Relationships, Featuring TPN.Health Member Corine Brown, DSW, LCSW-BACS

So far, the month of March in 2020 has offered a curious intersection of sociocultural stirrings. On on end, the world at large is swept up in navigating a pandemic. One response to COVID-19, according to Jones (2020) drawing from the work of Charles Rosenburg on outbreak archetypes, is that disease outbreaks serve to provide information about the foundational structures that drive the societies they strike. In this framework, a pandemic serves as a truth-telling device that reveals what a society truly values. 

In the spirit of unpacking societal values and as it is still Women’s History Month for all of March, let us remember #eachforequal, the theme of International Women’s Day 2020. The theme centers on the tenant of collective individualism, which upholds that each individual is part of a whole, and each individual’s unique participation in that whole has impact. Although the theme of collective individualism is impactful in society all the time, people’s interactions with this theme are particularly resonant at this time of the COVID-19 collective crisis, in which consequences are poignant across the barriers of race, age, gender, class, ability, etc.

In exploration of the theme of collective individualism and in light of the climate around COVID-19, TPN.Health has consulted member Corine Brown, DSW, LCSW-BACS on her experience as a practitioner working in emergency human services. As Director of Wellness Services at Covenant House, an emergency services organization, in New Orleans, LA, Corine has taken the organization in a direction that supports integrated collective mental health for the community, a direction oriented in addressing the challenges of a system where racism is inherent.

“What strikes me right now is how critical it is if practitioners do not have a practice of their own, if they have not done their own healing. How critical it has shown to be that we can actually hold space for this high level of collective anxiety.” -Corine Brown, DSW, LCSW-BACS

In the past year, Corine has completed her Doctorate of Social Work on barriers and solutions to institutional racism within the behavioral health field, focusing on consulting white-identifying people in positions of leadership about identifying those barriers and their needs in order to feel empowered to begin making changes. Informed from this research and years of experience working in emergency services at Covenant House New Orleans, Corine sees the current climate as a calling for practitioners to truly examine how they are in relationship with people, and that means first developing a personal practice of caring for and checking in with themselves.

“We say we value dignity and worth of a person. We say we value the importance of human relationships–integrity and competence. It is a really good idea for us to home in on what that actually means right now.” -Corine Brown, DSW, LCSW-BACS

Central to Corine’s work at Covenant House is cultivating empowerment. This means doing the work to hold space personally and collectively for people’s capabilities given their own power and limitations. Now, more than ever, it is a time to focus on defining and tapping into sources for that empowerment individually and in the context of one’s relationships. How can practitioners be empowered to do the inner work that will enable them to show up in ways that actually benefit and serve the people with whom they are working, not in theory but in reality? What does it mean to prioritize relationships with people? What does it mean to have integrity and competence? What does it mean to value the inherent dignity and worth of a person? There has never been a better time to intentionally spend time and energy exploring these questions.

Corine says of her work community, “I can’t tell you how relieved I am to be a part of Covenant House. Because we are so used to doing so much with so little, all we know is how to band together and figure it out.” As a person’s ability to support their community is inextricably linked to how they are supporting themselves, Corine is confident and full of hope that her community can actually handle times of collective upheaval, such as this, so long as people are doing the deep work of learning how to support themselves and one another.

Want to connect to Corine Brown, DSW, LCSW-BACS, and other trusted clinicians? Click here to create a TPN.Health clinical profile today and get access to channels of support– virtual CEUs, a trusted referral network, and connections to your clinical community.

References:

Jones, D. S. (2020). History in a Crisis — Lessons for Covid-19. New England Journal of Medicine. doi: 10.1056/nejmp2004361

Featured image credit: https://columbusfreepress.com/article/authentic-relating-games

You Are Not Alone.

We remind you, TPN.Health members, that you are part of a clinical community supporting its members in the collective mission to confidently navigate behavioral health. You are supported also in the shared experiences–the questions, challenges, and successes–of the professionals to whom are connected. 

Katie Godshall, LCSW, founder of the Behavioral Health Learning Collaborative (BLHC), and TPN.Health member, shares her unique perspective as a behavioral health professional navigating the work of clinical consultation, continuing education, as well as group and individual LCSW supervision on the shaky ground of COVID-19. 

Since Katie has adopted the practice of social distancing, the sense of disconnection from different organizations with whom she is partnered has been challenging. Social distancing has also bred the necessity to create a new clinical consultation format, for which Katie is presently working out the kinks. With uncertainty around how to proceed with the Louisiana State Board of Social Work Examiners (LABSWE) regulations that have not yet been adapted to COVID-19, such as the requirement for in-person supervision, she looks forward to LABSWE’s official COVID-19 responses, which are set to be announced after their meeting on Thursday, March 19th. 

“I think the move toward online therapy is a positive move. It is increasing overall accessibility, and it’s providing a normalization of getting mental health services.” -Katie Godshall, LCSW

With the danger of system-overwhelm for HIPAA-compliant technology, such as Telehealth, governing bodies have moved to lifted HIPAA regulations regarding online health services for some populations for the time being. This allows many practitioners and clients who are unfamiliar with HIPAA-compliant technology to smoothly transition into the exchange of online services on platforms with which they have familiarity, such as FaceTime or Skype. Even before the pandemic, Katie notes, there were so many misnomers about online therapy, such as the inability to get reimbursed for insurance or low effectiveness when compared to in person-therapy. This is a prime opportunity for people to become educated, first-hand, on the reality of moving behavioral health modalities to the digital realm. 

“I think we’re in a process of redefining therapy–what it is and what the purpose of it is, and I think that’s really scary for people.” -Katie Godshall, LCSW

Changes at this volume and depth require space to evaluate the behavioral health field in a new light, perhaps by engaging with questions differently and acknowledging that answers might not be immediate or straightforward. This is also a call for practitioners to consider what changes for now mean for the long-term. It’s never a bad idea to develop a plan. For instance, if you are brand new to online behavioral health services, how might the transition change your practice’s direction for the future? Will you still offer the option for online services to your clients post-COVID-19? If so, how will you prepare your clients for the inevitable transition back to HIPAA-compliant technology? It is Katie’s hope that all of these active shifts in response to COVID-19 will ultimately add to the benefits of being a clinician as well as improve the quality of services and support that clients need. 

Stay tuned as we explore more clinical reflections from the TPN.Health community. 

In these times of rapid change where so much is unknown, we are providing our community members with the vital resources to continue learning and growing as behavioral health professionals, specifically in a climate where interacting with technology is no longer a matter of choice but a matter of necessity. 

TPN.Health will be hosting a 3-CEU digital learning opportunity with speaker Parker Sternbergh, LCSW, Director of The Porter Cason Institute for the Family at Tulane School of Social Work, and TPN.Health Advisory Board Member. The content of the presentation, entitled Maintaining Ethics In An Expanding Digital World: The importance of a robust referral and communication mechanism in providing excellence in clinical services, will serve as a comprehensive overview of how to engage with digital tools so as to uphold and enhance best practices. 

We are also excited to bring the 3rd Annual Mental Health Association (MHA) Conference – 2020 Vision to TPN.Health members. The MHA conference for behavioral health professionals, which was supposed to take place in Baton Rouge, LA, on April 6-7 will be accessible digitally. More details to come.

Now is THE TIME  to create a TPN.Health clinical profile to access upcoming digital learning opportunities. Click here to get started.

Image Credit: https://www.weforum.org/agenda/2019/12/the-benefits-of-online-communities/

A Different View Of COVID-19 Featuring TPN.Health Member Angela James, LPC

As a response to the COVID-19 outbreak framed in Charles Rosenburg’s work on the archetypal structure of an outbreak, Jones (2020) offers that epidemics are social phenomena that reveal the structures that drive a society’s operation. He notes, “Rosenberg argued that epidemics put pressure on the societies they strike. This strain makes visible latent structures that might not otherwise be evident. As a result, epidemics provide a sampling device for social analysis. They reveal what really matters to a population and whom they truly value” (Jones, 2020).

In the spirit of unpacking societal values, let us not forget that the entire month March remains International Women’s Month. So, in continued celebration of International Women’s Month and in the theme of considering societal structures, TPN.Health draws from the perspective of Angela James, LPC, Assistant Director of the Accessibility Center at Tulane University in New Orleans, LA and clinician in private practice. With a passion for the inquisitiveness and boundary-pushing that trademark the college student spirit, Angela’s intention from the fledgling stages of her career was to work in higher education. Her entrance into the world of counseling stemmed from an exposure to counseling courses while pursuing her masters degree and the experiences she had with students while working in disability services. 

Angela James, LPC

She found that many of the students that frequented her office for help were black women who were not part of the disability services population. The frequent encounters with these black female students prompted Angela on a journey of anecdotal and academic research to address what she was seeing in her office. From her initial exploration of therapy as a healing modality for black women sprung a deep-dive into the nuances of the client-clinician relationship specifically when the client is a black woman, and the clinician is from a dissimilar cultural background. The deep-dive involves considering the relationship through a lens of cultural competence and historically significant constructs involving a web of interrelating topics, such as access and equity.

“I think listening is the best resource.” –Angela James, LPC

Angela emphasizes that the core of her work as a counselor, social justice advocate, and human being is centered on a practice of listening to those with whom she is in relationship. For Angela, this means not just saying, “I hear you,” for the sake of responding but actually taking in their perspective whose depth is unknown to you except through the words they speak. This is listening with the intention of considering that, just as you personally have a breadth of valid experiences informing your life, so do they, and you could stand to learn from their orientation. For instance, she sheds light on the importance of recognizing figure and ground when meeting people. She defines figure simply as “the immediate,” the living person standing directly in front of you. The ground, however, represents the goings-on of the world at large, which may be affecting a person’s realm of experience from a distance. She emphasizes the importance of considering how variables of the ground could be informing a person’s state of being in the world. 

Angela’s perspective is parallel to Jones (2020)’s reflection on the COVID-19 outbreak in that much of her work is centered around issues that, when unpacked, lay bare the internal structures of peoples’ lives that inform their relationships, occupations, and how they make sense of the world around them. In the same way, Jones (2020) illustrates that the pandemic serves as a mechanism to reveal the essential structures that drive a society’s day-to-day function. Ultimately, these parallel perspectives can inspire people, specifically behavioral health professionals, to steep in curiosity, deep listening, and consideration of all perspectives while operating in service of an approach that is oriented in research-informed action.

Angela is excited to use TPN.Health as a resource in continuing her work of creating a more inclusive community through a lens of social justice. She sees TPN.Health as an essential tool in the realm of cultural competence, specifically in that clinicians are enabled to feel confident around referring out when a client’s unique needs are outside of their realm of experience.

Looking to refer out? Want to access a diverse and trusted community of behavioral health professionals for networking and continuing education opportunities? Click here to create an clinical profile and begin interacting in TPN.Health today. There has never been a better time to be a part of this digital community!

References:

Jones, D. S. (2020). History in a Crisis — Lessons for Covid-19. New England Journal of Medicine. doi: 10.1056/nejmp2004361

Featured Image credit: https://www.freepik.com/free-vector/female-scientist-looking-through-microscope_6429942.htm