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In recognition of how common trauma is in society and in an effort to help address its devastating consequences on people’s mental health, clinical psychology has shifted towards becoming more trauma-informed. In the UK at least, it is an area of interest that candidates are being asked about more often during their doctorate interviews. Therefore, if you want to work in clinical psychology and if you’re an aspiring clinical psychologist then trauma-informed approaches are a critical area to understand. In this psychology podcast episode, you’ll what makes a psychologist trauma-informed, what are the 6 core principles of trauma-informed approaches and more. If you enjoy learning about trauma, mental health and clinical work then this is a great episode for you. Today’s psychology podcast episode has been sponsored by CBT For Anxiety: A Clinical Psychology Introduction To Cognitive Behavioural Therapy For Anxiety Disorders . Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. What Is A Trauma-Informed Approach? As I mentioned in the introduction to today’s episode, there is a big move within clinical psychology to become more trauma-informed. Due to psychologists need to be trauma-informed in recognition of how common trauma is in the world and as psychologists we need to respond to this harsh reality that trauma causes. For example, if I go off my own experience here, I’ve been through two types of trauma, one a single event and another form of trauma that stretched on for over a decade. As well as trauma is a wide-ranging umbrella term for different traumatic situations that might not affect some people but they might affect others. These can include child abuse, sexual violence, witnessing a murder, being a soldier and so on. Therefore, being trauma-informed means psychologists need to be aware of how trauma can impact an individual personally and societally too as well as psychologists need to anticipate how trauma survivors might respond to our actions and words so we don’t compound the damage and suffering that the trauma causes. In addition, this concept connects to the idea of secondary traumatisation. This is normally seen in forensic psychology where victims of crimes are traumatised again by going through the criminal justice system. Yet I see no reason why this cannot be extended to clinical psychology because if you have a clinical psychologist who isn’t trained in dealing with trauma and they make a mistake with a client by saying the wrong thing. Then I can easily see how this would retraumatised the client. For example, let’s take a personal example and talk about my child abuse during my adolescence and let’s use this situation in when I went to therapy last August. If my therapist wasn’t aware of trauma or LGBT+ issues and she said something that was blaming me for my abuse, my mental health and my situation then that would have been extremely damaging and it would only add to my trauma. Since in my mind, if a therapist cannot accept me and support me being gay and all the trauma I’m experiencing around it then no one can accept me. So my mental health would continue to decline. This is why psychological training is so important as well as having trauma-specific training is critical. Ultimately, being trauma-informed means psychologists are helping to create a world that can foster a client’s resilience, growth as well as healing. What Are The 6 Core Principles of Trauma-Informed Approaches? As you can probably imagine, all of us aspiring and qualified psychologists can say we want to be trauma-informed as much as we want but this intention isn’t enough alone. Also, when we consider just how many different examples of traumatic experiences there are and all the different types of trauma survivors, it’s very difficult to land on a narrow set of clinical guidelines that are going to be useful in every situation. This is why clinical psychologists have managed to come together to create a set of 6 guiding core principles that we can apply flexibly to each client as well as situation. The source behind these guidelines are the Substance Abuse and Mental Health Service Association (SAMHSA) in 2014, and now we’ll look at these 6 core principles. What Is Trustworthiness And Transparency In Clinical Trauma Work? The first principle we’ll look at isn’t directly linked to client work but trustworthiness and transparency is a principle focusing on helping clients to feel more willing to engage with the mental health service that we work in. When it comes to being trustworthy, this means we need to keep our promises, be reliable and we need to clearly show this towards our clients. Such as, we might say to our clients one thing and then follow up with the client with evidence to show that we’ve done this for them. One example is that if you say you’re going to email a medical doctor for some reason then you could show them the email you sent, of course whilst sticking to data protection and any other rules your service has in place. Furthermore, transparency helps clients to understand what your intentions and priorities are so the clients know where they stand with you as well as the mental health service. One way of putting this concept is it is the equivalent of “showing your work” when you try to solve a problem, so you might tell your client your thought process and what factors you considered when trying to make the clinical decision. Personally, I only just realised how brilliant transparency is because when I went for my counselling assessment for my sexual violence therapy, the psychologist doing the assessment told me a lot of “extra” information. For example, she explained why I wouldn’t be suitable to see a placement or trainee counsellor and she would talk to me and tell me what she was thinking as she was making notes. Therefore, she might have “only” been a psychologist assessing me but because she was completely transparent with me and she kept me informed of everything she was thinking, I felt really comfortable. And I am really looking forward to working with the service whenever I come off the waiting list. How Does The Safety Principle Make A Psychologist Trauma Informed? Whenever it comes to trauma, it is very common and a natural response for people not to feel safe. For example, me and my best friend were talking the other night because they asked me a question from the kitchen, they found it weird that whenever they asked me something I stop everything immediately and “ran” to them. I said that it was because if I didn’t come quickly in the past to someone asking me a question or if I didn’t do something quick enough then I would be shouted at or occasionally worse, and my best friend wanted me to learn that I am safe with them in our new house. And the same goes for the intense social anxiety I often have because of my sexual assault. It can be extremely difficult for trauma survivors to feel safe but without a feeling of safety clinical work is often doomed to fail. As a result, safety encourages clients to focus on the psychological intervention and support that is being offered so clients can feel emotionally and physically protected from danger. Also, it’s important that psychologists understand what makes clients feel unsafe so this can be very different across different trauma experiences and across different cultures. Such as when it comes to what makes me feel unsafe due to my sexual assault, big crowds, a dimly lit room and large men make me feel very unsafe. Then again before I dealt with my abuse, homophobia and older straight men would make me feel very unsafe, so it is different depending on the situation. In addition, it’s worth noting that safety doesn’t mean that things will always be easy for the client or even comfortable and it’s important to make this distinction at times. Since the idea of safety is built on the idea that a lot of trauma survivors lack a basic sense of safety (this is why I have so many panic attacks when I’m in public and meeting new people), and a lot of non-trauma survivors take their basic sense of safety for granted. As a result, when it comes to applying the safety principle in clinical work, it’s about levelling the playing field so all your clients can enjoy a basic sense of safety whenever they’re with you. So an individual might report feeling safe when they’re able to just stop scanning their environment for any threats or dangers for the hour they are with for you, and they’re no longer having to focus on defending or protecting themselves. And it is this basic sense of safety which causes me a lot of issues in my life at the moment because whenever I’m out and in a busy place, I am hypervigilant and hyperfocused on scanning my environment, watching out for anyone who would hurt me and so on. I understand that these are all illogical thoughts but it is still scary. How Does Empowerment, Voice And Choice Make A Psychologist Trauma-Informed? Our next principle focuses on making sure psychologists help clients to use their voice and power. Since trauma is a very disempowering experience so clients can be fearful and reluctant to step forward so it is up to psychologists to gently help and support clients to develop skills in this area that will help them become more empowered. For instance, helping to develop a client’s assertiveness and advocacy. As well as the interesting thing about all 6 of these core principles is that the more you embody all of them, the more likely clients are to be empowered too. As a brief personal example, one major issue I’ve had following my sexual assault is my disempowered and my inability to make decisions. For example, there are times when I simply cannot make decisions at all, including really tiny ones like in what cupboards to put my kitchen stuff in when I moved into my student accommodation. I simply couldn’t make a decision because I didn’t trust myself, I didn’t have self-worth and so on. And there are lots of different examples of disempowerment in the past few months and it is absolutely horrible. I don’t wish being paralysed with fear so you cannot function and make basic decisions on anyone. How Does Mutuality And Collaboration Make A Psychologist Trauma-Informed? In addition, our next principle takes this even further because it encourages clients to focus on who has power and who might be vulnerable to its misuse. Due to this principle is about a psychologist embodying collaboration and mutuality, a psychologist can help a client to reduce this power differential and its risks by engaging in more active collaboration across different levels of the service between clients and staff. For instance, a mental health service might get clients to give their input on the service (Collaboration and Mutuality) when considering a new policy or procedure then share how that information was used when the service was making its final decision (transparency). Ultimately, I think this connects to all clinical work and the importance of the therapeutic alliance. I know all therapy work is effectively a collaboration depending on the therapy module being used, but in trauma work, this is even more important because trauma survivors are already so disempowered. Then if a psychologist walked in, did a lot of things to the client without working with them and then kept doing this then the trauma survivor wouldn’t see any benefit because nothing would change. This so-called clinical work would only be a continuation of their disempowerment and trauma without anything changing. How Does Understanding Cultural, Historical And Gender Issues Make A Psychologist Trauma Informed? There are a lot of historical, cultural and gender issues that exist in the world and the vast majority of these impact trauma survivors, so it is flat out critical to understand how these issues impact trauma-informed work. This is why psychologists need to pay attention to the culture and world we live in so we can see the strengths, core values, social connections and resources that people might ignore. As well as psychologists need to understand how a historical context or how a client experiences discrimination might impact them but also how these experiences might frame how a client perceives our actions or policies. Due to by understanding these historical issues, we can have a better understanding of how to implement the other core principles in this episode. And when it comes to my personal trauma, these historical, cultural and gender issues are a major problem for me. Since my childhood trauma was caused by the cultural and historical issues around homophobia and how older people see and treat gay people. As well as when it comes to my sexual assault, the gender issue of being male and how the vast majority of people believe males don’t experience sexual violence is very challenging and it has compounded my trauma in more ways than I want to admit. So please, try to understand the different cultural, historical and gender issues that will impact your clients. It is a fascinating topic and it is flat out critical for trauma-informed work. How Does Peer Support Make A Psychologist Trauma-Informed? Our final trauma-informed principle focuses on how peer support can help clients find opportunities to learn and grow with other people who have lived experiences of trauma. Before on the podcast I’ve spoken about the benefits of group therapy and peer support groups is one of the three types. Peer support can be useful because it gives trauma survivors a chance to develop a stronger sense of belonging and it can support empowerment too because it is normally easier to speak up as a group than as a single individual. Clinical Psychology Conclusion When it comes to trauma-informed work, this is flat out critical for aspiring and qualified psychologists because a trauma-informed approach isn’t just about the students or clients that we work with, to be honest. It is about our fellow psychologists, staff and our leaders at our mental health services, as well as ourselves, who could be trauma survivors. Our clients are not the only trauma survivors in the world. Therefore, these 6 core principles can be used in everyday context and setting, even if you’re not working with trauma survivors explicitly, because all these principles can be useful in clinical work. As well as even when you’re working with your peers, it is always good to make them feel safe, be transparent and collaborate with them and more. Sometimes I feel like just knowing how to be more trauma-informed helps you to become a better person and after this podcast episode, I believe that even more. To wrap up this trauma episode, it needs to be said that these principles need to be applied flexibly because chances are they will look very different depending on the type of trauma you are working with now or in the future. Yet they are still important because these principles have the power to transform and heal our relationships, our mental health services and maybe even ourselves if we’re trauma survivors. Working with trauma might sound scary to a lot of people, but as a trauma survivor myself, yes what I experienced and went through was utterly terrifying. But I am not a victim that needs to be treated carefully, like a child or like I am anything other than a regular human being who has been through hell and back. I am simply a survivor trying to live my life as much as I can but I need psychological help for that and that is where all of us come in now or in the future. Clinical trauma work might sound scary but it can probably be some of the most rewarding work we might ever do as psychologists. And we might transform lives for the better even more than usual.   I really hope you enjoyed today’s clinical psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET CBT For Anxiety: A Clinical Psychology Introduction To Cognitive Behavioural Therapy For Anxiety Disorders . Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Clinical Psychology References and Further Reading Champine, R. B., Lang, J. M., Nelson, A. M., Hanson, R. F., & Tebes, J. K. (2019). Systems measures of a trauma‐informed approach: A systematic review. American Journal of Community Psychology, 64(3-4), 418-437. Chu, Y. C., Wang, H. H., Chou, F. H., Hsu, Y. F., & Liao, K. L. (2024). Outcomes of trauma‐informed care on the psychological health of women experiencing intimate partner violence: a systematic review and meta‐analysis. Journal of Psychiatric and Mental Health Nursing, 31(2), 203-214. Cutuli, J. J., Alderfer, M. A., & Marsac, M. L. (2019). Introduction to the special issue: Trauma-informed care for children and families. Psychological Services, 16(1), 1. Forkey, H., Szilagyi, M., Kelly, E. T., & Duffee, J. (2021). Trauma-informed care. Pediatrics, 148(2). Han, H. R., Miller, H. N., Nkimbeng, M., Budhathoki, C., Mikhael, T., Rivers, E., ... & Wilson, P. (2021). Trauma informed interventions: A systematic review. PloS one, 16(6), e0252747. Maynard, B. R., Farina, A., Dell, N. A., & Kelly, M. S. (2019). Effects of trauma‐informed approaches in schools: A systematic review. Campbell Systematic Reviews, 15(1-2). Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014 I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon  page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley  for a one-time bit of support.

If you’ve ever done cognitive psychology before then you might be aware that people only learn and retain information if it enters the long-term memory. To achieve this and improve their learning, students and adults use a wide range of strategies to help them learn new information. Yet these different strategies are different levels of effective so in this cognitive psychology podcast episode, we’re going to learning about one of the most effective ways of learning new information. By the end of this podcast episode, you’ll understand what retrieval-based learning is, why is it effective and some of neuropsychological mechanisms underpinning this learning strategies. If you enjoy learning about the psychology of learning, neuropsychology and biological psychology then you’ll love today’s episode. Today’s psychology podcast episode has been sponsored by Retrieval-Based Learning: A Cognitive Psychology and Neuropsychology Guide To Learning . Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Note: as always all the references for this podcast episode can be found at the bottom of the blog post. What Is Retrieval-Based Learning? (Extract from Retrieval-Based Learning . COPYRIGHT 2024 CONNOR WHITELEY) Kicking off this book and as I mentioned in the introduction, we’re going to be following the structure of my dissertation and I’m going to introduce you to this brilliant and really interesting topic before explaining more about the experiment itself. Therefore, we can probably know, learning is critical in everyday life from learning how to ride a bike to how to revise effectively for exams to how to drive a car, learning is everywhere, and we also know that learning requires a lot of cognitive skills including memory retrieval as retrieval enhances learning (Roediger & Karpicke, 2006). Knowing the above is important because it is this understanding of the skills behind learning that lead to the development of retrieval-based learning tasks. As well as this is where learners’ re-access newly learnt stimuli by undergoing tests. Typically, participants in a retrieval-based learning task have an initial learning phase, where learners are tested on said stimuli, next is a testing phase, where the learners are tested on this material. Also, retrieval-based learning tasks utilise various combinations of these study-test blocks. Such as, STST, STTT, etc (Pyke et al., 2021). Whereas when a researcher decides to use a control condition, in this case learners aren’t tested on the learnt material and all learners complete a final assessment to measure their overall learning, with these assessments taking place minutes (Smith et al., 2013) or months (Carpenter et al., 2009) after the previous phases. You’ll see how we did this in two chapter’s time. In addition, retrieval-based learning tasks have been found in research to be beneficial for a wide range of populations, including patients (Friedman et al., 2017), children (Lipowski et al., 2014) and older adults (Coane, 2013) and retrieval-based learning reliably shows increased long-term retention of learnt stimuli compared to study-only conditions (Agarwal et al., 2008; Fazio & Marsh, 2019; Karpicke & Grimaldi, 2012; Roediger & Butler, 2011). Personally, after learning and looking at that small introduction to retrieval-based learning, I have to admit that this type of learning is really interesting. Because something me and the girls I was working with said was that when we were first introduced to the project we weren’t sure if this was going to work. Since this literature sounds great and very, very impressive but don’t all overexaggerated things? Like social priming, the research sounds amazing, for example the idea that holding a warm mug of coffee can make you more positive. It sounds fun and great but the research is beyond stupid. That’s sort of what me and my friends thought about retrieval-based learning when we first encountered it, but I promise you it really is amazing and fascinating to see in action. Anyway, the very notion of learning via retrieval started in the early 20th century (Abbott, 1909; Gates, 1917, Spitzer, 1939) and it was Bjork’s (1994) Desirable Difficulties Framework that bought the idea of difficulty and effort into the forefront of retrieval-based learning and it does nicely fit with retrieval-based learning for this reason. Due to the Framework proposes an effective way to improve long-term retention by learnt stimuli is to introduce a desirable amount of difficulty (effort) whilst learning. Furthermore, the role of effort in retrieval-based learning can be explained by the Retrieval Effort Hypothesis (REH) which is consistent with Bjork’s (1994) framework because the REH states the more difficult retrieval is, the more effort the learner requires and this increases the probability the material will be consolidated in the long-term memory and make the retrieval easier later on as supported by several studies (Carprenter & DeLosh, 2006; Karpicke & Roediger, 2007b; Pyc & Rawson, 2009). Nonetheless, the biggest problem with this theory is that REH has been criticised for being too descriptive (Karpicke et al., 2014) and fails to explain how effort could produce memory benefits. As well as the literature agrees it remains difficult to truly compare cued recall and free recall tests because of aspects like false alarm rates and response pressure in cued recall tests (Ozubko, 2011). What Theories And Models Explain The Effectiveness Of Retrieval-Based Learning? In addition, this is where we get into the information that isn’t covered in my project because I didn’t feel like it was relevant to the actual focus of the investigation. But I want to include it in here because it helps to explain the general background to learning better. As a result, a range of theories have been put forward over the decades to explain the effectiveness of retrieval-based learning. One such theory is the Stretch Theory  (Murdock & Dufty, 1972; Norman & Wickelgren, 1969; Wickelgren & Norman, 1966) because this provides researchers with a general theoretical model for recognition memory, where the more information is recalled or “remembered” the stronger the memory trace. Leaving a physical record of the memories in the brain (Thompson, 2005) and the more this is recalled the easier the information is to recall in the future. Moreover, another theory is the Transfer Appropriate Processing (TAP) theory and this states the initial practise test prepares the participant for the final test by eliciting a similar type of working memory processing compared to studying the material alone (Roediger & Karpicke, 2006). Consequently, the testing effect, where the performance difference between the study-only and RBL group, is greater when the task used in the initial encoding is the same as the final test. This is where the baseline and training sessions aren’t similar to all the testing phases we use because we wanted to make sure the performance of the participant was down to them learning and not the Testing Effect. Thirdly, the Bifurcation model proposed by Kornell et al. (2011) states during a retrieval-based learning condition using free or cued recall tests without corrective feedback, a split occurs in later recall tests. Successfully retrieved items on an initial test creates a stronger memory trace, compared to items that are forgotten. Therefore, creating a bifurcated item distribution where initially recalled items are more likely to be remembered later on compared to items that are forgotten. In other words, participants are more likely to remember correct answers than wrong ones because during the training sessions the correct answers make a stronger memory trace so these are recalled later, and the wrong answers are forgotten. What Is An Alternative Theory To REH? Personally, I would have liked to include this theory in my project but I did understand how this didn’t really add anything to the final submission. Yet I really did want to add it in this book so you can understand how learning happens according to a wide range of theories and models. Nonetheless, you might have noticed that all the above theories and models focus on the idea of the learner having to put effort into learning and there’s the idea of a physical memory trace. But are there any other ideas to explain the effectiveness of retrieval-based learning? One alternative theory is the Cognitive Load Theory (CLT) by Sweller (1988) and Sweller et al. (1998) and this aims to explain the link between cognitive load (processing load) and how this impacts a learner’s ability to manage new information and learning tasks and how this is later built into knowledge in the long-term memory. In addition, this theory is built on three critical assumptions. Firstly, the long-term memory consists of schemas categorising information based on how it will be used (Chi et al., 1982) and has an unlimited capacity. Secondly, the working memory has limited capacity and consists of multiple semi-independent subsystems. These two assumptions form a third where learning is most effective when instructional procedures are used limiting the working memory load whilst concurrently encouraging schema formation. In terms of research support for Cognitive Load Theory, the evidence mainly comes from studies that show the supporting effects that the theory proposes (Sweller et al., 1998). For instance, the goal-free effect, this is where learners encounter a novel problem without a schema readily available to help them, making the learners engage in a means-end Analysis (MEA), where they identify a goal state and problem state. Once they’ve done this, these two states require the learner to reconcile the differences between the states using a problem-solving operator (Sweller, 1988) and if no goal state is clear for the learner, they identify the problem state and apply a problem-solving operator to this problem. The theory is backed by practice as research shows in multiple experimental contexts this method reduces working memory load and increases schema construction, resulting in improved memorisation (Ayres, 1993; Bobis et al., 1994; Owen & Sweller, 1985; Vollmeyer et al., 1996). What Is Transfer Effect? Now that we understand a lot about learning and how retrieval-based learning works from a theoretical standpoint, let’s move onto what the project actually focused on, or at least the viewpoint that I wanted to explore in depth for the sake of my dissertation. I really wanted to focus on something known as Transfer Effect. This is a theory that is officially called Transfer Appropriate Processing (TAP) or Transfer Effect and this is the proactive use of prior learning in a novel context (Pan & Rickard, 2018) with this brand-new context potentially referring to any situation that is somehow different to the context the learning originally took place in (McDaniel, 2007). Such as, a different test type, goal or topic (Barnett & Ceci, 2002). In addition, this links to effort because the TAP proposes a process of spreading activation occurs during the search for answers on a test (Anderson, 1996; Collins & Loftus, 1975; Raaijmakers & Shiffrin, 1981), creating multiple retrieval cues to aid later recall. This results in the testing effect (Pan & Rickard, 2018) and Pan and Rickard (2018) believed Transfer Effects could result from the same mechanism, because semantically-related information similar to the previously learnt stimuli needs to be recalled on a transfer test. As a result, the process of spreading activation that presumably occurs during the initial testing increases the likelihood this learnt information will be recallable as well (Carpenter, 2011; Chan, 2009; Chan, McDermott, & Roediger, 2006; Cranney, Ahn, McKinnon, Morris, & Watts, 2009) suggesting participants implicitly employ techniques to carry out learning resulting in effort likely being reduced. On the whole, Pan and Rickard (2018) concluded test-enhanced learning could yield transfer performance substantially better than non-testing re-exposure conditions. This supports this paper’s examination as our Retrieval-Based Learning task will help to provide further evidence for the efficacy of test-enhanced learning and Transfer Effects. In other words, Transfer Effect is all about how a learner applies the learning they did in one context and transfers that learning to another similar context so they can do just as well as they did in the same similar context. As we go on through the book, you’ll understand how this happens in our training sessions.   I really hope you enjoyed today’s clinical psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Retrieval-Based Learning: A Cognitive Psychology and Neuropsychology Guide To Learning . Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Cognitive Psychology References and Further Reading Whiteley, C. (2024) Retrieval-Based Learning: A Cognitive Psychology and Neuropsychology Guide To Learning CGD Publishing. England Abbott, E. E. (1909). On the analysis of the factor of recall in the learning process. The Psychological Review: Monograph Supplements , 11 (1), 159–177. https://doi.org/10.1037/h0093018 Agarwal, P. K., Karpicke, J. D., Kang, S. H., Roediger III, H. L., & McDermott, K. B. (2008). Examining the testing effect with open‐and closed‐book tests. Applied Cognitive Psychology: The Official Journal of the Society for Applied Research in Memory and Cognition, 22(7), 861-876. Anderson, J. R. (1996). ACT: A simple theory of complex cognition. American Psychologist, 51, 355–365. http://dx.doi.org/10.1037/0003- 066X.51.4.355 Ayres, P. L. (1993). Why Goal-Free Problems Can Facilitate Learning. Contemporary Educational Psychology, 18(3), 376–381. https://doi.org/10.1006/ceps.1993.1027 Barnett, S. M., & Ceci, S. J. (2002). When and where do we apply what we learn?: A taxonomy for far transfer. Psychological Bulletin, 128(4), 612–637. https://doi.org/10.1037/0033-2909.128.4.612 Bjork, R. A. (1994). Memory and metamemory considerations in the training of human beings. In Metacognition: Knowing about knowing. (pp. 185–205). https://books.google.com/books?hl=en&lr=&id=Ci0TDgAAQBAJ&oi=fnd&pg=PA185&ots=qG4y4uPvYs&sig=dDuK6kAtBmrkeOe5AsfI3nmK3aM Bobis, J., Sweller, J., & Cooper, M. (1994). Demands imposed on primary-school students by geometric models. Contemporary Educational Psychology, 19(1), 108–117. https://doi.org/10.1006/ceps.1994.1010 Carpenter, S. K. (2011). Semantic information activated during retrieval contributes to later retention: Support for the mediator effectiveness hypothesis of the testing effect. Journal of Experimental Psychology: Learning, Memory, and Cognition, 37(6), 1547–1552. https://doi.org/10.1037/a0024140 Carpenter, S. K., & DeLosh, E. L. (2006). Impoverished cue support enhances subsequent retention: Support for the elaborative retrieval explanation of the testing effect. Memory and Cognition, 34(2), 268–276. https://doi.org/10.3758/BF03193405 Carpenter, S. K., Pashler, H., & Cepeda, N. J. (2009). Using tests to enhance 8th grade students' retention of US history facts. Applied Cognitive Psychology: The Official Journal of the Society for Applied Research in Memory and Cognition, 23(6), 760-771. Chan, J. C. (2009). When does retrieval induce forgetting and when does it induce facilitation? Implications for retrieval inhibition, testing effect, and text processing. Journal of Memory and Language, 61(2), 153-170. Chan, J. C. K., McDermott, K. B., & Roediger, H. L. III. (2006). Retrieval-induced facilitation: Initially nontested material can benefit from prior testing of related material. Journal of Experimental Psychology: General, 135(4), 553–571. https://doi.org/10.1037/0096-3445.135.4.553 , Glaser, & Rees. (1982). Expertise in problem solving. In R. Sternberg (Ed.), Advances in the Psychology of Human Intelligence (pp. 7–75). Erlbaum, Hillsdale. Coane, J. H. (2013). Retrieval practice and elaborative encoding benefit memory in younger and older adults. Journal of Applied Research in Memory and Cognition, 2(2), 95-100. Collins, A. M., & Loftus, E. F. (1975). A spreading-activation theory of semantic processing. Psychological Review, 82, 407– 428. http://dx.doi .org/10.1037/0033-295X.82.6.407 Cranney, J., Ahn, M., McKinnon, R., Morris, S., & Watts, K. (2009). The testing effect, collaborative learning, and retrieval-induced facilitation in a classroom setting. European Journal of Cognitive Psychology, 21(6), 919-940. Fazio, L. K., & Marsh, E. J. (2019). Retrieval-based learning in children. Current Directions in Psychological Science, 28(2), 111-116. Friedman, R. B., Sullivan, K. L., Snider, S. F., Luta, G., & Jones, K. T. (2017). Leveraging the test effect to improve maintenance of the gains achieved through cognitive rehabilitation. Neuropsychology, 31(2), 220. Gates, A. I. (1917). Recitation as a factor in memorizing. Archives of Psychology, 6(40). https://archive.org/stream/recitationasafa00gategoog?ref=ol#page/n22/mode/2up Karpicke, J. D., & Grimaldi, P. J. (2012). Retrieval-based learning: A perspective for enhancing meaningful learning. Educational Psychology Review, 24(3), 401-418. Kornell, N., Bjork, R. A., & Garcia, M. A. (2011). Why tests appear to prevent forgetting: A distribution-based bifurcation model. Journal of Memory and Language, 65(2), 85–97. https://doi.org/10.1016/j.jml.2011.04.002 Lipowski, S. L., Pyc, M. A., Dunlosky, J., & Rawson, K. A. (2014). Establishing and explaining the testing effect in free recall for young children. Developmental Psychology, 50(4), 994. McDaniel, M. A. (2007). Transfer: Rediscovering a central concept. In H. L. Roediger, Y. Dudai, & S. M. Fitzpatrick (Eds.), Science of memory: Concepts. New York, NY: Oxford University Press. Murdock, B. B., & Dufty, P. O. (1972). Strength theory and recognition memory. Journal of Experimental Psychology. https://doi.org/10.1037/h0032795 Mussel, P., Ulrich, N., Allen, J. J., Osinsky, R., & Hewig, J. (2016). Patterns of theta oscillation reflect the neural basis of individual differences in epistemic motivation. Scientific reports, 6(1), 1-10. Norman, D. A., & Wickelgren, W. A. (1969). Strength theory of decision rules and latency in retrieval from short-term memory. Journal of Mathematical Psychology. https://doi.org/10.1016/0022-2496(69)90002-9 Owen, E., & Sweller, J. (1985). What Do Students Learn While Solving Mathematics Problems? Journal of Educational Psychology, 77(3), 272–284. https://doi.org/10.1037/0022-0663.77.3.272 Ozubko, J. (2011). Is Free Recall Actually Superior to Cued Recall? Introducing the Recognized Recall Procedure to Examine the Costs and Benefits of Cueing. A Thesis Presented to the University of Waterloo. Pan, S. C., & Rickard, T. C. (2018). Transfer of test-enhanced learning: Meta-analytic review and synthesis. Psychological bulletin, 144(7), 710. Pyc, M. A., & Rawson, K. A. (2009). Testing the retrieval effort hypothesis: Does greater difficulty correctly recalling information lead to higher levels of memory? Journal of Memory and Language, 60(4), 437–447. https://doi.org/10.1016/j.jml.2009.01.004 Pyke, W., Vostanis, A., & Javadi, A. H. (2021). Electrical Brain Stimulation During a Retrieval-Based Learning Task Can Impair Long-Term Memory. Journal of Cognitive Enhancement, 5(2), 218-232. Raaijmakers, J. G., & Shiffrin, R. M. (1981). Search of associative memory. Psychological Review, 88, 93–134. http://dx.doi.org/10.1037/0033- 295X.88.2.93 Roediger III, H. L., & Butler, A. C. (2011). The critical role of retrieval practice in long-term retention. Trends in cognitive sciences, 15(1), 20-27. Roediger III, H. L., & Karpicke, J. D. (2006). Test-enhanced learning: Taking memory tests improves long-term retention. Psychological science, 17(3), 249-255. Smith, M. A., Roediger III, H. L., & Karpicke, J. D. (2013). Covert retrieval practice benefits retention as much as overt retrieval practice. Journal of Experimental Psychology: Learning, Memory, and Cognition, 39(6), 1712. Spitzer, H. F. (1939). Studies in retention. Journal of Educational Psychology, 30(9), 641–656. https://doi.org/10.1037/h0063404 Sweller, J. (1988). Cognitive Load During Problem Solving: Effects on Learning. Cognitive Science, 12(2), 257–285. https://doi.org/10.1207/s15516709cog1202_4 Sweller, J., Van Merrienboer, J. J. G., & Paas, F. G. W. C. (1998). Cognitive Architecture and Instructional Design. Educational Psychology Review, 10(3), 251–296. https://doi.org/10.1023/A:1022193728205 Thompson, R. F. (2005). In search of memory traces. Annu. Rev. Psychol., 56, 1-23. Vollmeyer, R., Burns, B. D., & Holyoak, K. J. (1996). The Impact of Goal Specificity on Strategy Use and the Acquisition of Problem Structure. Cognitive Science , 20 (1), 75–100. https://doi.org/10.1207/s15516709cog2001_3 I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon  page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley  for a one-time bit of support.

For the vast majority of people, giving birth is a beautiful, wonderful and amazing experience that means they get to bring new life into the world. Yet for a lot of women, giving birth can be a very traumatic, hard and awful time in their life because childbirth can be overwhelming. As well as mothers can find it overwhelming to immediately transition from childbirth to the early stages of becoming a mother, meaning there is no time for the new mother to recover physically and emotionally after childbirth. Also, whilst women are told it should take about 6 weeks for their recovery to happen, in reality, there is no recovery time because of the new responsibilities and demands of being a new parent. This is often forgotten about by the majority of people (myself included). Therefore, in this clinical psychology podcast episode, we explore why can childbirth be potentially traumatic for women, and how does birth trauma burden a mother. If you enjoy learning about mental health, clinical psychology and trauma then this is a fascinating episode for you. Today’s episode has been sponsored by Applied Psychology: Applying Social Psychology, Cognitive Psychology And More To The Real-World.  Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Why Is Childbirth Potentially Traumatic? When it comes to birth trauma, there are a few main ways how this can become a traumatic experience for a new parent. Firstly, childbirth by its very nature disturbs the body’s equilibrium as well as the mother’s sense of security and creates a severe disruption that requires rebalancing and recuperation. Secondly, for a lot of women, childbirth can be emotionally traumatic too because childbirth can involve unexpected interventions, complications, awful interactions with medical staff, postpartum complications as well as childbirth is an extremely intense process. All these different factors can leave scars on a mother by disrupting her sense of safety and decreasing her mental health. In addition, what is even worse is that as a society, we don’t allow women the time to heal and recover from the emotionally and physically demanding process of childbirth. We simply kick them out of hospital with their new baby, expect them to immediately take on all the new responsibilities and unless the woman has an amazing social support network and family, then she doesn’t get time to recover at all. As well as even if the woman does have a great social support network, because of the weakened state of paternal leave and other support for new parents, sometimes the partner and other sources of support just cannot be there for the new mother. More on this later on. How Does The Isolation And Pressure Of Being A New Mother Impact Women? When I first came across this point, I was very surprised that being a new mother can be isolating because I didn’t understand how. Then I got thinking about how bringing a beautiful new baby into the world brings a lot of challenges that limit a new mother from seeing their friends, going out and doing a lot of things that people normally do to feel socially connected. Moreover, a new mother immediately has to deal with the demands of being a new mother by dealing with breastfeeding, sleepless nights, hormonal imbalances and the potentially overwhelming responsibility of caring for a newborn baby. And this is where the isolation and pressure part of motherhood comes into play, because of this new life the mother experiences is all-consuming and abrupt. Essentially, your life changes overnight forever and this leaves very little space for women to address any birth trauma or for them to reflect on their birth experiences. Of course, I am flat out not saying that mothers should not look after their newborns nor am I saying that mothers shouldn’t enjoy the experience of early motherhood, and I am not saying mothers shouldn’t partake in the responsibilities they now have. What I am saying is that mothers need and they should ask for the social support if they need it, so they can lessen some of this burden and pressure. This will allow them to process their birth experience and any birth trauma too, and getting social support will help the new mother enjoy the experience of early motherhood more as well. Additionally, when it comes to isolation in early motherhood, this happens because there is an awful silence around birth trauma. No one wants to talk about it and in society, there are unrealistic pressures placed on new mothers. For example, in society, there is a big idea that motherhood is only a time for joy, fulfilment and pure happiness and if you don’t feel those things then you are a failure as a mother. That is completely wrong and it ignores the complexities of early motherhood as well as all the struggles that different women may face. Ultimately, this silence and idealised version of motherhood leads to stigma that makes women feel guilty and ashamed for not immediately embracing the role of early motherhood with gusto, joy and pure excitement. Also, this stigma only prolongs any birth trauma they’ve experienced because it makes women scared to speak out and seek the psychological support they need. All because they don’t want to be judged and criticized for not living up to this idealised version of motherhood. How Can We Support New Mothers After Birth Trauma? After learning about why birth trauma can burden a new mother, we need to focus on how do we fix this to improve the lives and experiences of new mothers. It goes without saying that the childbirth process as well as the early stages of motherhood will always be challenging and tender in their own way for each woman. Yet the main problem with the current process is childbirth doesn’t have to be set up unfairly for the women going through childbirth. Since as a culture and society, we need to create a more supportive environment for new mothers so new mothers can feel understood, heard, nourished and protected as they recover from the physically and emotionally demanding challenge of childbirth. As well as recover from any birth trauma that they experience. In addition, we need to encourage more honest and open conversations about birth trauma as well as early motherhood. This would allow us to cultivate an authentically support environment where women can feel safe to share their birth trauma and other non-idealised experiences without any fear of judgement. Thankfully, this will help to reduce the feeling of isolation and improve the mental health of new mothers in other ways too. As well as we need to create conditions for new mothers that allow them to properly heal and steady themselves so they can prepare for what raising a child will require. Moreover, when it comes to healthcare providers, we need to put pressure on them to develop new approaches, new systems and interventions that support a new mother’s physical and mental health. This will help to decrease some birth trauma in the first place by decreasing postpartum complications and supporting a new mother’s recovery. Ultimately, it doesn’t matter what your gender is, if you want children or not or whatever your thoughts are towards giving birth, we all need to recognise the importance of allowing women enough time and resources to physically and emotionally recover after childbirth to best protect their mental health going forward. Clinical Psychology Conclusion Something I realised during the writing of this podcast episode was just how much I questioned whether or not I should be writing this in the first place. Since I am not a woman and whether my future involves children or not is questionable but I think I did this topic justice because I want to introduce all of us to the topic of birth trauma. I don’t want to sit and let fear hold me back when there are a lot of great women who are struggling with birth trauma and negative birth experiences and they don’t feel like they can come forward because of the stigma. Therefore, that’s why I do these sort of “unconventional” clinical psychology podcast episodes, because I want to help people. And maybe there’s a woman listening to this and she feels glad to learn she isn’t the only woman going through this and there is help and support available to her if she needs it. It’s a hope. Anyway, when it comes to transitioning from childbirth to early motherhood, this can be a challenging and overwhelming time for new mothers, and that’s okay. It doesn’t make a mother a bad person, an unfit mother or anything negative if she finds it overwhelming and non-idealised. For the rest of us, we need to take steps towards creating a culture where we’re more understanding and empathetic towards women who have had birth trauma and negative birth experiences. We can create this culture by empowering women to navigate this transition with resilience and by supporting women to reclaim their well-being and sense of agency during the transition. Ultimately, this silence around birth trauma has to end and as current and aspiring clinical psychologists, we need to help do this to protect the mental health of women, so they feel empowered enough to seek mental health support if they need it. We need to make sure that every woman has the chance to heal and recover with the time and resources they need, so they can embark on the great journey of motherhood. A journey that will be challenging, hard and it will seem flat out impossible at times, especially for mothers who have experienced birth trauma. Yet with the right physical and mental health support, motherhood really can be fun, amazing and one of the most fulfilling experiences you’ll ever have.   I really hope you enjoyed today’s clinical psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Applied Psychology: Applying Social Psychology, Cognitive Psychology And More To The Real-World. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Clinical Psychology References and Further Reading Ayers, S. (2017). Birth trauma and post-traumatic stress disorder: the importance of risk and resilience. Journal of reproductive and infant psychology, 35(5), 427-430. Chrzan-Dętkoś, M., Walczak-Kozłowska, T., & Lipowska, M. (2021). The need for additional mental health support for women in the postpartum period in the times of epidemic crisis. BMC pregnancy and childbirth, 21, 1-9. https://www.psychologytoday.com/gb/blog/mindfully-present-fully-alive/202407/the-unspoken-burden-of-birth-trauma Nakić Radoš, S., Matijaš, M., Kuhar, L., Anđelinović, M., & Ayers, S. (2020). Measuring and conceptualizing PTSD following childbirth: Validation of the City Birth Trauma Scale. Psychological Trauma: Theory, Research, Practice, and Policy, 12(2), 147. Simpson, M., & Catling, C. (2016). Understanding psychological traumatic birth experiences: A literature review. Women and Birth, 29(3), 203-207. Watson, K., White, C., Hall, H., & Hewitt, A. (2021). Women’s experiences of birth trauma: A scoping review. Women and Birth, 34(5), 417-424. I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon  page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley  for a one-time bit of support.

Whenever people think about psychosis, they only think it involves hearing voices and paranoia. Yet psychosis involves so much more than hearing voices, in fact it involves 4 categories of symptoms. Therefore, in this clinical psychology podcast episode, you’ll learn about what are the positive, negative, disorganised and catatonic symptoms of psychosis. If you enjoy learning about psychosis, mental health and clinical psychology then this is a great episode for you. Today’s psychology podcast episode has been sponsored by Clinical Psychology: Second Edition . Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. What Are The Four Categories Of Psychotic Symptoms? What Are The Positive Symptoms Of Psychosis? I certainly think that the term “positive” is one of the weirdest terms in psychology because there is nothing “good”, “exciting” or “happy” about psychotic symptoms and they can be extremely distressing to individuals with the condition. Yet what positive actually means in this context is “additional experience”. Therefore, when we talk about positive symptoms, what we actually mean is symptoms that add an extra experience to the client’s life and perceptions. Two examples of this include hallucinations as well as delusions. Hallucinations are internally generated sensory experiences because there is nothing in the person’s environment that is generating these voices, visions, smells, noises or tactile experiences that are very real to the person. Interestingly, smells, taste and tactile experiences are very rare hallucinations to experience in psychosis without there being an underlying medical condition or the effects of a substance. If a client is experiencing these three symptoms then they should be referred for a medical evaluation. On the other hand, delusions are fixed, false beliefs that people with psychosis hold with great conviction because they are convinced these beliefs are true even without any supporting evidence. At times, these delusions are believable or plausible in nature and these are known as non-bizarre delusions. For instance, if someone with psychosis believes they might be cheated on, they might be pregnant, have a disease or someone is plotting against them. Personally, I wasn’t sure if I was going to include this in today’s episode but the reason why I wanted to research psychosis more is because of persecutory delusions. This is where someone strongly believes someone or a group of people is out to harm them, and a woman I know verbally attacked me because of these delusions. It led to a whole thing in our social group and it was messy. Thankfully, everyone in our friendship group knows this woman has a few mental health conditions and that I would never hurt her, so even though I avoid her like the plague now. I really hope she’s okay. In addition, you can have bizarre delusions where these are highly unlikely or just impossible in nature. Such as, people with psychosis believing that other people can hear their thoughts or aliens have implanted thoughts inside their head. And some of the most bizarre delusions are nihilistic in nature, like a person believing they don’t exist. Finally for this section, it’s useful to note that delusions and hallucinations are not exclusive of each other. Often people with psychosis have both of these examples of positive symptoms. What Are The Negative Symptoms Of Psychosis? Whilst the positive psychotic symptoms are probably the most well-known, the negative symptoms are very common too. These symptoms include an absence of experiences and other things that should be present in a “healthy” client. For instance: ·       Cognitive impairment- including an inability to focus and have a slow cognitive processing speed. ·       Avolition- an inability to do the things someone wants to do. ·       Poverty of speech content- when the person speaks their words lack any substance. ·       Poverty of speech or mutism- typically this involves one-word or simple verbalisations or a complete lack of speech. ·        Inappropriate or flat facial or emotional expressions- a lack of expression or an expression that is incongruent to the content. Such as, talking about being scared whilst grinning. ·       Thought blocking- this is when the person with psychosis clearly has something they want to say or they’re in the process of saying and then they fall silent. Interestingly, they still appear to have something to say and on their mind but they just can’t get it out. ·       Social withdrawal- they’re disengaged from others and people with psychosis often report this is because they often don’t feel like they fit in because of their mental health condition or paranoia. What Are the Catatonic Symptoms of Psychosis? When a lot of people think about people in catatonic states, they often believe the person is in an unmovable, withdrawn and silent state. However, in reality, a person in a catatonic state can be excited or withdrawn so this means we need to split catatonic symptoms into two different categories. Firstly, when someone is in an excited catatonic state, they can act impulsively, seem agitated, perform meaningless and repetitive movements, mirror other people’s movements and echo other people’s noises or verbalisations. Secondly, when someone is in a withdrawn catatonic state, they tend to hold strange postures for hours and they can be placed in a posture by others as well. Or they might remain rigid for hours so they’re resistant to being moved by other people. Also, people in a withdrawn catatonic state don’t tend to have facial expressions or speak at all, even though at times they might grimace and have no response to an external stimuli. What Are Disorganised Psychotic Symptoms? It means there are a few weird terms when it comes to mental health because yet again, this is a term that doesn’t mean what we typically associate with it. Instead of being a mess and clutter, “disorganised” symptoms mean people with psychosis experience severe thought disorganisation. There are six different examples of this thought disorganisation. Firstly, “clanging” involves a person with psychosis using a “singsong” or rhyming speech pattern so the person is more interested in how they’re saying sounds to themselves compared to what they’re actually saying. Secondly, you can experience circumstantial thought processes where a person with psychosis doesn’t get to the point of what they’re saying linearly. Since there are a lot of extra, unneeded details that make the listener lose sight of the topic of the conversation but the person eventually ties it all together. And this example is a good reminder about why diagnosis needs multiple symptoms for a range of time and these symptoms have to cause clinically significant levels of distress in multiple domains of functioning. Due to everyone does this thought process every so often and I’ve had conversations with people who do this naturally without psychosis, so it is the combination of other symptoms that means someone has psychosis. Thirdly, loose associations involve a person with psychosis drawing parallels between two related items. As well as flights of ideas or thought derailment include clients jumping between topics without fully completing their thoughts. Then if the derailment is severe, then a client might be talking about their favourite car and then start talking about an unrelated topic without a transition or warning. Moreover, word salad involves a gross inability for the person with psychosis to form any sort of verbal cohesion so the words just pour out in a massive jumbled mess. Finally, neologism means “new words” so someone with psychosis can say words that don’t make much (or any) sense except to the client. Then the client tries to use these new words to describe some experience they’ve had but don’t have the words to describe it. Clinical Psychology Conclusion Whilst this was definitely one of the more information-heavy podcast episodes that we’ve done in recent months, and I wasn’t able to add in too many of my own thoughts and feelings on the topic (besides from being attacked and berated by someone with persecutory delusions, my experience of psychosis is just academic), I still enjoyed it. Since psychosis is a popular mental health condition to have in books, films and TV programmes and whilst I always prefer positive depictions of mental health conditions, this doesn’t happen with psychosis. This leads people to believe psychosis is only hallucinations and delusions, but psychosis is so much more than that as shown in today’s episode. And I hope you found it as interesting, thought-provoking and eye-opening as I did.   I really hope you enjoyed today’s clinical psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Clinical Psychology: Second Edition . Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Clinical Psychology References and Further Reading Best, M. W., Law, H., Pyle, M., & Morrison, A. P. (2020). Relationships between psychiatric symptoms, functioning and personal recovery in psychosis. Schizophrenia research, 223, 112-118. Davey, G. C. (2021). Psychopathology: Research, assessment and treatment in clinical psychology. John Wiley & Sons. Davey, G., Lake, N., & Whittington, A. (Eds.). (2015). Clinical psychology. Routledge. Davies, C., Radua, J., Cipriani, A., Stahl, D., Provenzani, U., McGuire, P., & Fusar-Poli, P. (2018). Efficacy and acceptability of interventions for attenuated positive psychotic symptoms in individuals at clinical high risk of psychosis: a network meta-analysis. Frontiers in Psychiatry, 9, 187. Geekie, J., Randal, P., Lampshire, D., & Read, J. (2012). Experiencing psychosis. Personal and professional perspectives. Longden, E., Branitsky, A., Moskowitz, A., Berry, K., Bucci, S., & Varese, F. (2020). The relationship between dissociation and symptoms of psychosis: a meta-analysis. Schizophrenia bulletin, 46(5), 1104-1113. Parra, A., Juanes, A., Losada, C. P., Álvarez-Sesmero, S., Santana, V. D., Martí, I., ... & Rentero, D. (2020). Psychotic symptoms in COVID-19 patients. A retrospective descriptive study. Psychiatry research, 291, 113254. Read, J., Bentall, R., Mosher, L., & Dillon, J. (Eds.). (2013). Models of madness: Psychological, social and biological approaches to psychosis. Routledge. Swora, E., Boberska, M., Kulis, E., Knoll, N., Keller, J., & Luszczynska, A. (2022). Physical activity, positive and negative symptoms of psychosis, and general psychopathology among people with psychotic disorders: A meta-analysis. Journal of Clinical Medicine, 11(10), 2719. I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon  page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley  for a one-time bit of support.

Whether you’re a parent yourself, you know a child or you’re a child therapist then there are certain things you just need to know about child therapy. These facts can help child therapy be more successful, “easier” and it can improve the life of the child in the long term. I remember talking to a doctor once who worked with teenagers with eating disorders and she mentioned how the parents were the actual problem and main barrier to treatment. And if parents just knew a few more things then maybe the treatment would have been more successful sooner. Therefore, in this clinical psychology podcast episode, you’re going to learn about what do clients need to know about child therapy. There are a lot of great points in this episode so if you enjoy learning about psychotherapy, child mental health and parenting then this is a great episode for you. Today’s psychology podcast episode has been sponsored by Working With Children And Young People: A Guide To Clinical Psychology, Mental Health And Psychotherapy.  Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. What Do Clients Need To Know About Child Therapy? One reason why I wanted to do today’s episode is because this is a very light episode compared to the trauma-related ones, but there are a lot of myths surrounding child therapy. A lot of parents are nervous, scared and resistant to their child needing therapy so they either don’t take them even though the child badly needs the support, or they create barriers to treatment. Something that only harms and doesn’t help the child or young person. In addition, even though this podcast episode might be framed towards parents and non-psychology people, there is still a lot of aspiring and qualified psychologists can learn from this episode. Since this can help us to understand what are some the things and barriers that we might need to address with parents in therapy. Now, we need to bust some of these myths and start learning more about child therapy. There Needs To Be Trust To Help Your Child When it comes to child therapy, therapists can’t help a child unless the child and the parent trust the therapist. This connects to the idea of confidentiality because this is a key part of the therapeutic relationship and a lot of different states and countries have strict laws around confidentiality for children. Some states in the United States of America have laws where the young person has near absolute confidentiality so the parents cannot access any information about their child’s therapy sessions. Whereas other states have laws where the parent has all the permissions that the young person has. Whatever the situation in your state or country, a parent will be told when the therapist believes there is a serious risk to your child’s safety. This always includes if your child is making plans for suicide. I understand if parents are scared or nervous about the idea of confidentiality and the vast majority of parents want to know everything about their child so they can protect them. This is perfect in theory but in practice this just doesn’t work, because children don’t share things or too much without the protection of confidentiality. Ultimately, without a level of confidentiality the therapy will not be successful for the child and the child will keep suffering. Personally, when I went to try and get my autism diagnosis back in 2019 during my first year at university because my parents refused to get me diagnosed beforehand and I was struggling badly. I remember it being one of the first questions I asked the university team, will my parents be told about this. And if the answer was yes then I was going to refuse to have the initial meeting because it simply wasn’t worth the risk. It’s taken took them about 4 years to be open to supporting an autism diagnosis but I needed it a decade ago. So it just goes to show how important confidentiality is when it comes to being open and wanting to tell a stranger (also known as the therapist) personal information. Parents Might Need to Come To Their Child’s Therapy Session Whilst this won’t be all the time, child therapy often involves therapy sessions with family members. Especially when childhood trauma is involved because in Trauma-Focused Cognitive Behavioural Therapy (we have a podcast episode about this in the future) (Kliethermes et al., 2017) does emphasise the need for a child and caregiver to have sessions together as part of the therapy process. In addition, we do these family sessions because they can be really beneficial to the young person because it gives them a place to express what they’re feeling and these family sessions can be powerfully healing. As a result, if a therapist invites you to a family session, this isn’t because the therapist wants to punish you, shout at you and say you are the worst parent in existence. This is just a normal part of the therapeutic process. Personally, I definitely get the immense power of family sessions because honestly, it would have been lovely to have some family sessions for my situation last August. It would have been more structured, more focused and more healing for all of us I think. As well as even towards the end of my breakdown in August/ September 2023 when I had this massive conversation with my family about what they had done, how they had made me feel and everything because of the homophobia and other things. It was very healing, powerful and it did change our family for the better. Therefore, there is immense healing in open and honest conversations so it is critical to attend these appointments when you’ve been invited to them. Psychologists Are Experts In Therapy and Practise, Not Experts In Your Child Even though clinical psychologists and other mental health professionals are highly trained and skilled professionals, we aren’t experts in your child. Yes, the vast majority of therapists have achieved a Masters’ degree or a doctorate so they’re been in higher education for at least 6 to 8 years, and they received Continued Professional Development even that after. We acknowledge there is a lot more to family and people than you can ever learn in a classroom. This is why despite psychotherapy training giving therapists the specific skills to practise different types of psychotherapy, we know that some of the techniques and experiential activities and strategies we use might seem mysterious to a parent because they don’t know why we’re doing them. For example, let’s face it an art therapy activity looks really weird when you think about it. Especially because most laypeople believe therapy is only laying on a couch talking about your mental health difficulties, so when a parent hears their child is making art, that just smashes into the myths and confuses them. Whereas in reality, an art therapy activity can be very useful in helping a young person to challenge a self-limiting belief or building rapport with them, before the more in-depth therapy work begins. Ultimately, if a parent is ever confused about an activity, strategy or whatever is going on in therapy, then therapists want the parent to ask them questions. Parents shouldn’t suffer in silence and it is more than okay to ask questions and want to understand more. Make Sure Your Child Comes To The Appointment I was rather surprised when I came across this one because I had no idea this was a real thing. I couldn’t believe there were times when a parent just didn’t take their child to an appointment. Or I’m honestly not naïve enough to think clients always turn up to appointments but in an ideal world, they would because you cannot get the professional help if you aren’t there. Of course this can be difficult at times, especially with children. Therapists understand that after-school clubs and family activities can make getting to a therapy appointment difficult at times because most therapists do have a few appointments outside of school hours. I talk more about this in a book coming out next year, but I was so happy and so impressed when a charity I’m working with had some 5 pm to 8 pm therapy appointments. Those out-of-hours appointments are seriously impactful and potentially life-changing for a client. Moreover, therapists really hope that parents want to work with them to make a time work for the therapy session, because everyone wants the child to be okay and thrive. And I think the most important aspect to realise here is that missing a therapy session certainly is not like missing a football or trumpet lesson. Missing therapy sessions add up and these missing sessions can throw a young person off if they’re working through a particular treatment. Also, a lot of clients and parents don’t know this, but therapists put a lot of time and thought into creating effective, evidence-based interventions outside of these therapy sessions. So I feel like it’s a little disrespectful to not try to make the therapy session when the therapist has put in a lot of work into them. Ultimately, it is attending therapy sessions that give the therapy the best chance of working, being successful and helping your child. Parents Need To Know Seeking Therapy Is A Wise Thing, It Isn’t Shameful I was always going to end on this note because I strongly believe this is the most important message to focus on, and I see this in my own family. At the time of writing, there are more children and young people in therapy than ever. I don’t think this is because the world is more dramatic, everyone is a snowflake or whatever else the idiots say. I think this is because stigma is thankfully decreasing, therapy is more accessible and people are becoming more aware of when they need help. Furthermore, whatever the reason why a child or young person comes to therapy, there is no shame to it. It’s okay if a child comes to therapy to work on a particular goal, to work through some trauma or a mental health difficulty or if they want to better themselves. All of those reasons and more are valid, shameless reasons to come to therapy. I know I always talk about this but it’s important to note that there is nothing wrong with you if you come to therapy. And the same goes for your family or parents, there is nothing wrong with them if your child comes to therapy. You wouldn’t hesitate in reaching out to a medical doctor if your child or young person was having heart problems or had a physical condition, so parents need to realise the same goes for mental health. Reaching out for mental health support is just like reaching out for other kinds of health support. Ultimately, reaching out for mental health support is an act of love and it shows that you care about their health and well-being. From personal experience, all I’ll say is that this is a million times better than knowing your child is struggling and just leaving them to it because you believe the stupid myths about children with mental health conditions have to go on medication and they’re barred from going to university. Clinical Psychology Conclusion  I always enjoy learning about myths and misconceptions that people create for themselves or others when it comes to therapy. In this episode, we looked at how parents need to trust us so we can help their child, parents might need to come to their child’s family sessions, how psychologists are experts in therapy but not the child, parents need to make sure children come to their appointments and how going to therapy is wise. It’s a massive shame that there are a lot of these myths that become engrained into the fabric of society so parents, aspiring therapists and everyone believes these damaging ideas. But if you’re a current or future parent then I hope you now understand how important it is that your child goes go to therapy if they need the support, and you understand the truth behind some of these myths and misconceptions. If you’re an aspiring or qualified psychologist, then again, I hope you understand the truth now. Yet I also hope you might bring these ideas forward into your work or they make you more aware of what the parents of our clients are going through. They will probably believe at least one of these myths and that will create a barrier to treatment that needs to be addressed so the young person can be helped and thrive. Since that really is the job of a child therapist, of course it’s about improving the child’s life, giving them new adaptive coping mechanisms and decreasing their psychological distress. But ultimately, child therapy is all about making sure a child can thrive for decades to come.   I really hope you enjoyed today’s clinical psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Working With Children And Young People: A Guide To Clinical Psychology, Mental Health And Psychotherapy.  Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Clinical Psychology References and Further Reading Adams, D., & Young, K. (2021). A systematic review of the perceived barriers and facilitators to accessing psychological treatment for mental health problems in individuals on the autism spectrum. Review Journal of Autism and Developmental Disorders, 8(4), 436-453. Babatunde, G. B., van Rensburg, A. J., Bhana, A., & Petersen, I. (2021). Barriers and facilitators to child and adolescent mental health services in low-and-middle-income countries: a scoping review. Global Social Welfare, 8, 29-46. Gee, B., Wilson, J., Clarke, T., Farthing, S., Carroll, B., Jackson, C., ... & Notley, C. (2021). Delivering mental health support within schools and colleges–a thematic synthesis of barriers and facilitators to implementation of indicated psychological interventions for adolescents. Child and adolescent mental health, 26(1), 34-46. Hamilton, A., Mitchison, D., Basten, C., Byrne, S., Goldstein, M., Hay, P., ... & Touyz, S. (2022). Understanding treatment delay: perceived barriers preventing treatment-seeking for eating disorders. Australian & New Zealand Journal of Psychiatry, 56(3), 248-259. Kliethermes, M. D., Drewry, K., & Wamser-Nanney, R. (2017). Trauma-focused cognitive behavioral therapy. Evidence-based treatments for trauma related disorders in children and adolescents, 167-186. Radez, J., Reardon, T., Creswell, C., Lawrence, P. J., Evdoka-Burton, G., & Waite, P. (2021). Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. European child & adolescent psychiatry, 30(2), 183-211. Weisenmuller, C., & Hilton, D. (2021). Barriers to access, implementation, and utilization of parenting interventions: Considerations for research and clinical applications. American Psychologist, 76(1), 104. 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Today’s podcast episode comes out two days after me and my best friend moved in together for the next academic year and it’s just the two of us for 2-and-a-half months before two more of our friends join us. And even though me and my best friend aren’t a couple, it got me thinking about the sort of topics couples should talk about before they move in together to minimise conflict, arguments and relationship breakdown. Therefore, in today’s social psychology podcast episode, we discuss a wide range of topics any couple (and friends for that matter) should talk about before moving in together. I’ll add in some personal commentary and thoughts to bring this episode alive, so this should be a great one for everyone. Especially if you like learning about relationship psychology, social psychology and couple behaviour. Today’s podcast episode has been sponsored by Psychology of Relationships: The Social Psychology of Friendships, Romantic Relationships and More . Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Note: as always absolutely nothing on this podcast is any sort of official advice whatsoever including relationship advice. Why Should Couples Talk About Certain Topics Before Moving In Together? I firmly believe that all couples should sit down and have a detailed conversation about cohabitation before they live together, because this is a major step in any relationship. To use a close friendship example (as that’s all I know), it is very different seeing your best friend for hours at a time, a few times a week compared to living and being around each other 24/7, so for the sake of the relationship you cannot simply just go into it. You need to think about if this is right for you or not. Granted when it comes to this sort of thing, because of my past, I am an extremely cautious person. In terms of relationships, a couple wanting to move in together signs a desire for greater commitment and intimacy. So it’s important that the partners have conversations that help the other to understand their preferences, expectations as well as perceptions of the relationship. This is something I needed to understand a lot more about my best friend, in terms of perceptions, because I’m used to getting dropped and abandoned by people I get close with, so I needed a fair amount of reassurance. And my best friend was the same a few years ago so they understood. As a result, Brown et al. (2023) wrote a paper about the topics that couples needed to talk about before they moved in together in the form of questions. This helps the couple to talk about communication, household rules and relationship negotiations to help keep conflict at a minimum. What Are The Relationship Negotiation Questions? When it comes to Brown et al. (2023), they suggest couples talk about 4 main areas of their relationship so each partner can understand the other person more. These areas and questions are: Purpose Of Cohabitation ·       How permanent is the pre-cohabitation agreement? What is our end goal as a couple? ·       What are some problems that moving in together may trigger or exacerbate? ·       How will we share and organize the new space? Should we share our individual belongings or purchase new ones? ·       Does this location suit us both (e.g., proximity to family, friends, or work)? ·       How do we agree on the definitions of concepts, such as cohabitation, infidelity, monogamy, household rules, and shared labour? Personally, I think these are good questions these “purpose” questions help you to understand each other more and you can get ahead of some of the problems or concerns you both have. As well as your partner’s answers can be very reassuring. For example, when me and my best friend were talking about moving in together, I found it really reassuring that we spoke about some issues that might pop up. Like, them and their relationship would be a potential issue for me because of my child abuse and sexual assault, so we spoke about it. This is just something we’re going to have to manage when it pops up and I’ve recommitted to working on it and trying to find my own relationship in the future. Of course, that is still difficult being a sexual assault survivor. In addition, it was really reassuring that we both agreed on just talking to each other if something pops up, and talking about location, household rules and how we would manage chores was useful too. Overall, this isn’t about finding reasons not to live together. Instead this is about finding out more information so you know more about your relationship so you can decrease the chance of major conflict. Sex And Romance ·       When or how frequently to discuss sex and intimacy—be it masturbation, pornography, contraception, frequency of sex, freedom to explore desires and fantasies, getting tested for STDs, or open relationships (e.g., swinging)? ·       What are the rules for discussing sex in front of other people? ·       Do we have the same expectations when it comes to date nights and holidays, including where to go, what to wear, and who pays? Thankfully, this is an area me and my best friend did not have to talk about, but I think this is still important for couples. Since it helps put everything into perspective and it allows you to know exactly what the other person wants. Culture, Family and Religion ·       How involved are we going to be with our own and each other’s families? ·       How to address family issues? ·       Which cultural traditions to share? ·       When to talk about sociopolitical issues, like the way race, gender, or disabilities affect our relationship? ·       How important is spirituality/religion to each of us and our families of origin? This is a critical section because you do need to know this stuff. If the other person is a devout member of a religion and you are not, then you need to know this and what that entails. This could be a dealbreaker for you so you will have to come to a compromise that means your partner can practice without the religion constantly being forced down your throat. Also, if you both have different positions on sociopolitical issues then this is important to talk about. You can still have a great relationship even if you don’t agree on everything, but the key is to respect each other and know when to talk openly about your beliefs. Thankfully, me and my best friend agree on 99% of stuff politically and socially so this isn’t a problem. Yet the one topic we do disagree on, I know not to talk about unless it’s the right time or place. Granted, this isn’t a rule, this is just something I wanted to do to decrease conflict. Ultimately, I think this set of questions comes back to respecting your partner as a separate person with their own life and belief system. That isn’t a bad thing and often a few differences can make a relationship more interesting. Individual and Shared Identities ·       Do we plan to have separate spaces in the house (for some "me time")? ·       How to maintain our individual and shared time, goals, hobbies, and other relationships (e.g., friends, coworkers)? Continuing on with our mini-theme of respecting your partner, these last two questions confirm that even more. It is important that you find time for yourself, your hobbies, your interests and your friends because you can’t be around each other 24/7. That would lead to burnout, you would get sick and tired of each other and it wouldn’t be good for the relationship at all. This is why having these conversations and making sure you both want alone time away from each other is important. In terms of me and my best friend moving in together, this is something we are sort of aware of. Since I have my business, my writing and my podcasting that takes up a lot of my time. Also, me and my best friend have Outreach work at our university so that can be done together or alone. As well as my best friend has their Dungeons and Dragons campaigns, their own friends and they want to spend the summer building a gaming PC from scratch. Therefore, we will be spending a lot of time together, especially in the evenings, but we aren’t going to be around each other and attached at the hip 24/7. Something that will be really good for our relationship going forward. What About Household Rule Questions?  This is certainly an area where a lot of conflict can pop up so these questions are certainly important and critical to talk about. What About Chores? ·       What is a flexible and fair way of splitting up the chores? ·       How to make decisions about grocery shopping (diets, brands), cooking (scheduling, leftovers), doing laundry (frequency, folding techniques), cleaning (vacuuming, doing the dishes), and outside maintenance (mowing the grass, shovelling snow)? This is even more important when it comes to student housing to be fair, so what me and my best friend are going to do is there will be a whiteboard with a list of chores, and one of our names will be next to each chore. It’s that person’s job to do that chore each week and we swap every week.  That’s fair and I don’t have a problem with that method. I know my parents are a little more gender-based because of their age so my Mum does the more typical female jobs round the house, and my Dad does the typical male jobs. Yet when I move out I know my Dad is going to have to start doing the stuff I did like the food bin, dishwasher, hanging out the washing on the washing line from time to time and a few other pieces. Basically, just talk to your partner and work this stuff out now before you move in together. Believe me, you do not want an argument about chores not being done and someone seeing the other in the relationship as lazy. Those arguments never go well. What About Debt, Budgeting and Finances? ·       Do we have similar views regarding spending and saving, financial contribution, making shared purchases, bank accounts (joint vs. separate), debts (including debts from previous relationships), and systems of managing finances? ·       Should we make a budget (e.g., for travel, emergencies, large purchases)? ·       What are our financial resources (incomes, savings, and investments)? What about recurring expenses and bills? ·       When to revisit our financial goals? Whilst this is basically null-void for student housing because everything is the person’s own responsibility, when it comes to relationships this is important because you’re together and financial decisions impact both of you. And because these conversations can be so detailed, so depend on your upbringing, your attitude towards money and a whole bunch of other factors, all I will say is make sure you have these conversations. I think money can make or break a relationship, so please don’t let money issues mess up yours. What About Pets? ·       Does either of us have any pet allergies? Who will be responsible for the costs and daily care of the pet(s)? Again similar to money, this is a needed conversation because if one of you really wants a dog or cat but the other is allergic, this is something you need to know about now. Also, if you want a pet but the other doesn’t, this will be disappointing and it’s healthy to know why so you can understand where the other person is coming from. For example, my Mum would flat out love a dog but my Dad seriously doesn’t. Mainly because of the cost, the price of the actual dog and my parents like going away for weekends at a time so their lifestyle doesn’t always accommodate a dog. It was that little explanation that helped my Mum understand why my Dad was so against this, so it prevented this disagreement ever becoming an issue in the relationship. What About Guests? ·       How long or frequently can we have guests over? How much notice is required? I think this is an answer that will change depending on the level of your relationship. For example, if you’re a relatively new couple then you may be more forgiving of surprise guests, but if you’re married, you do need to tell each other with notice about guests coming and staying around. In terms of me and my best friend, we often make fun of our tenancy agreement because the legal contract specifically says something along the lines of we are limited to two guests a month and they cannot stay for more than two nights in a row and they cannot stay more than 4 nights in a month . Or something stupid like that. So the agreement we mentioned in passing was the other can always bring friends over as long as they tell the other, and if my best friend brings their partner over then I want notice because we’ll probably have to talk about it a little. Not because I don’t want my best friend in a relationship (I seriously do and I just want them to be happy) because of my sexual assault and child abuse stuff. Ultimately, this question about guests is simply being respectful because if you’re living with someone, this is their house too. You cannot treat it like you’re the only person who lives there, because that isn’t fair. So just talk to your partner about guests out of respect for them. What About Transportation? ·       How to budget for transportation expenses—be it public transportation, renting a car, or maintaining a vehicle we own? How to share a car (e.g., drop-off schedule)? I sort of understand the wording of this question but I also don’t like it. I don’t really think budgeting for transportation is a major concern depending on where you live. I think a more important question is about the shared car if you only have one. I think that needs to be sorted out so conflict doesn’t arise by one partner not feeling like they can use it if needed, and the other partner doesn’t get annoyed because the other used their car without permission. I’ve already said to my best friend I will drive them to Outreach events if we’re both working it, and I will drive them about if it’s local and whatever. For example, I’ll take them to the shops, train station and whatever if it’s convenient for me. I’ll also take them to the university most of the time to some extent because it’s a five minute drive away. I wanted to have this conversation so my friend knows I’m happy to help them out and they don’t have to stress about getting public transport and whatever. What About Communication Questions? The final set of questions looks at how to manage communication in the relationship when you move in together. Questions About Rules of Communication ·       When do we discuss relationship issues? Are we planning to use regular check-ins and, if needed, conflict resolution techniques or psychotherapy? Conflict is always going to pop up so please plan for it so you have a plan of action to sort out any issues. Don’t let the issues go unresolved because this isn’t healthy in a relationship and it can be the small things adding up over time that causes the relationship to utterly fail. Even if you promise each other just to talk about any issues or conflict, or when the other annoys you (that’s what me and my best friend have agreed) then this is better than nothing. Questions About Communication Needs and Styles ·       Should we set aside time to talk about our day, and to schedule time to discuss major relationship issues? ·       When bothered by an issue or feeling upset, how will each partner communicate those feelings? What verbal and non-verbal cues (gestures, body language) to look for? This connects to the last group of questions because it’s important you resolve and talk about conflict, but you also need to know how you talk and communicate these issues so you can both effectively deal with the issue. Questions About Social Media and Privacy ·       What is private? How do we differentiate privacy from secrecy? ·       How much time are we each going to spend on social media? ·       What are the expectations regarding posting about our relationship on social media? This is an interesting one because I never would have thought about this topic and these questions but I can understand why these are important. Since it is really annoying when you’re spending time with someone and the other person is constantly on their phone or social media, in the early days of Facebook my Mum used to do this a lot and it was annoying. And if one person in the relationship doesn’t want to be on social media or “advertise” the relationship on social media a lot then you need to know this to avoid conflict. Logistical Questions ·       What is each person’s daily routine? ·       How do we share our personal and professional schedules? This is something me and my best friend need to talk about a bit more because we will work fine together and living together will be great. But we have reasonably different routines, and routines are important to us because we’re both autistic. For example, I get up at around 8 am (I try 7 am but that doesn’t happen these days), I do 6 hours of work throughout the day with longish breaks in-between so I can do my steps, watch online courses and whatever. Then I’m normally in bed by 10 pm (okay, I’ll lying in bed doing Duolingo and reading). My best friend gets up at 11 am or 12 pm and doesn’t go to bed until midnight or even 2 am in the morning. However, it’s just useful to think about daily routines and how you might need to adapt them now you’re living together. This helps decrease any conflict and it allows you both to keep living your own lives without you feeling like you are getting lost in the relationship. What About LGBT+ Issues? ·       How “out” are each of us? ·       Might there be negative legal, financial, or social consequences to telling others about cohabitation? How to manage or reduce the negative consequences? If this is relevant to your situation then these are probably some of the most important questions you will talk about, and that’s all I’ll say about this generally. With me being gay and my best friend being bisexual and both of us are fully out to our friends and families, this isn’t going we need to hide or not talk about when our parents or family visit us. That’s reassuring but equally, there are some stuff we know not to tell the family of the other. For example, I don’t think I’ll be allowed to tell my best friend’s parents any details of their relationships when they visit, and I’m not allowed to tell my best friend’s partner about my best friend’s past relationships because he’s sensitive to that sort of stuff. So just talk, be honest and be considerate towards the other. Goals and Plans Questions ·       What are each person’s plans and goals—be they related to physical health, mental health, emotional well-being, or finances and career development? ·       What are our future plans (e.g., marriage)? These questions are rather interesting because they’re ones I would never normally think about. Part of that is probably just down to me never being in a relationship, but when couples move in together these are important questions to consider. They mean you can help each other move towards your goals, you can grow as a couple and individuals and again, this helps you to define yourself and your own individual identity so you don’t lose yourself in the relationship. And if your partner has very different goals and plans to yourself, then talk about it. See if these are dealbreakers, see if you can compromise and how you can help each other. Exit Strategy Questions ·       Do we have a plan for the possibility of relationship dissolution, including ways of dealing with legal issues? ·       How might we split the assets, liabilities, and debt? What about the marital home (e.g., mortgage)? Finally, whilst no one ever wants to think about exit strategies and relationship breakdown, these are good to think about when moving in together. Since moving in together adds some legal considerations like the mortgages, the rent, the bills and more, so you need to know what happens if you decide to break up. Social Psychology Conclusion Ultimately, when it comes to moving in together a lot of couples never take the time to have an open and honest conversation about topics that would help them to understand their partner’s views, plans, preferences, desires, routines and so on. However, if you don’t have these conversations then living together can be very stressful and filled with conflict. You might need to address sexual satisfaction, division of chores, budgeting, communication styles and needs as well as what to do if living together doesn’t work out. As a result, when you want to live with your partner, definitely aside time to chat about the topics we’ve discussed in this episode and see these are opportunities to improve and develop your listening skills. As well as improve how you express yourself,  your planning, perspective-taking and improve your intimacy building. These are all critical skills for healthy romantic relationships. If these topics cause you a lot of anxiety and if you cannot find solutions or come to an agreement, then maybe consider couples therapy. We’ve covered this a lot on the podcast before so please check out the backlist. On the whole, even though me and my best friend aren’t dating, I am still really looking forward it to because it will be fun, we’ll have a great time together and it will be a massive improvement in both our lives. But I’ll admit because of my past, I was scared of it, I was nervous and I thought this was impossible at first. However, we took the time to talk about it over the course of a few months (and I’m neglecting the fact we got a house 4 days after confirming it then we had these conversations. Do not do that when you’re dating them) and I am a lot more relaxed now and I’m really, really looking forward to it. Give yourself and your relationship the best chance of survival and having fun whilst living together. So just talk, communicate and respect each other. That really is the key to a happy cohabitation.   I really hope you enjoyed today’s social psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Psychology of Relationships: The Social Psychology of Friendships, Romantic Relationships and More . Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Social Psychology References and Further Reading Brown, K. S., Schmidt, B., Morrow, C., & Rougeaux-Burnes, G. (2023). Pre-cohabitation conversations for relationships: Recommended questions for discussion. Contemporary Family Therapy, 45(2), 131-145. Brown, S. L., Manning, W. D., & Wu, H. (2022). Relationship quality in midlife: A comparison of dating, living apart together, cohabitation, and marriage. Journal of Marriage and Family, 84(3), 860-878. Foran, H. M., Mueller, J., Schulz, W., & Hahlweg, K. (2022). Cohabitation, relationship stability, relationship adjustment, and children’s mental health over 10 years. Frontiers in Psychology, 12, 746306. Manning, W. D. (2020). Young adulthood relationships in an era of uncertainty: A case for cohabitation. Demography, 57(3), 799-819. Willoughby, B. J., Carroll, J. S., & Busby, D. M. (2012). The different effects of “living together” Determining and comparing types of cohabiting couples. Journal of Social and Personal Relationships, 29(3), 397-419. I truly hope that you’ve enjoyed this blog post and if you feel like supporting th e blog on an ongoing basis and get lots of rewards, then please head to my Patreon  page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley  for a one-time bit of support.

As a result of homophobia, transphobia and minority stress amongst other factors, there is a higher rate of mental health difficulties and conditions in the LGBT+ community compared to the general population. Also, LGBT+ individuals are more likely to be hate crimed and experience trauma in their lifetime so the need for psychological support and therapy is high. However, straight therapists often worry about whether they should work with a gay client or not because of the differences between them. In this clinical psychology podcast episode, you’ll explain why straight therapists should definitely work with gay clients and most importantly what should therapists know working with gay male clients. This is all about increasing awareness and helping the therapy to be more successful. If you enjoy learning about clinical psychology, minority stress and trauma then this is a great episode for you. Today’s psychology podcast episode has been sponsored by Clinical Psychology: Second Edition. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. What Should Straight Therapists Know When Working With Gay Male Clients? Something I actually like a lot more than I would ever admit is when someone eventually finds out I’m gay or non-binary, they ask me respectful questions about it. Sometimes these are trauma or clinical psychology-related questions because I talk about those aspects of my past on the podcast a fair bit to help bring the material alive. Or they’re more general questions about life, love and attraction. As long as you ask questions respectfully then everyone is always more than happy to answer. Also, straight therapists can absolutely work with gay male clients and any other client from the LGBT+ community. You might need to ask some extra questions compared to straight clients but that’s fine. LGBT+ people have no unique mental health conditions compared to straight people. They only have different stressors at times because the heteronormative and cissexist world we live in. In addition, whilst working with a gay therapist is the preferred option for any gay clients (the exact same way how straight men prefer to have a male therapist and so on), there are great advantages to working with a straight therapist. Mainly because if the client has grown up in a very homophobic and anti-gay world then being accepted and listened to by a straight therapist could be immensely powerful in their healing. Therefore, for the rest of this podcast episode, we’re going to be focusing on the different things straight therapists should be aware of when working with a gay male client. Why You Shouldn’t Assume He’s As Highly Functioning As He Appears? This is one of the main things to know about gay male clients (or anyone who has trauma) because all gay men experience differing degrees of trauma by growing up in a heteronormative world where being straight is seen as natural and the default, and being gay is seen as weird or definitely not normal. Therefore, gay men often adopt, internalise and bury the shame this creates and occasionally this leads gay men to not even remember or want to remember what really happened to them in their earlier life. Personally, another fact I find really interesting as a psychology student so I never fell into this trap, but a lot of gay men play down the importance of early life events on their adult life. This means that therapists are going to need to tease out these themes of trauma as well as shame even if these themes aren’t the presenting problems that the client has when the therapy begins. But there is a more nuanced take on that point that I’ll mention later on. In addition, something that can happen behind the scenes when a gay man has therapy with a straight therapist is that you two will be talking about the surface-level reasons about why he’s here. Yet because you’ll have a warm, accepting tone, he’ll internalise that acceptance and it will give him something bigger and far more powerful in terms of healing than whatever the male client came in for. Since the acceptance that you’re giving him will go far beyond your words and you are effectively giving him the background for major lasting change in the client’s life. All because unconsciously he would have been preparing himself to be judged harshly because that’s basically all he knows. I’ve mentioned this before on the podcast but this is why I developed emotional dependency on a friend I made in July/ August 2023 because he was so accepted, he didn’t care I was gay and he really liked spending time with me. For someone who came from a background of never having that and never being accepted or even tolerated, there was a strangely wonderful feeling. And my mental health was great during those few months because I was accepted and I had a friend to go out and do things with. Of course, I took this to the unhealthy level, and the vast, vast, vast majority of clients would never ever do that. Yet I’m telling you this because it shows how powerful being accepting can be. Overall, this all comes back to not judging your client to be as high-functioning as he appears because underneath the strong exterior, there might be a lot of trauma, pain and hurt that other people have caused him. And that goes for a lot of mental health conditions and trauma experiences. Even before I went for therapy because of my homophobic upbringing and everything that entailed, I was in fear for my life, I was doing a lot of maladaptive coping mechanisms and I looking back I was a wreck at times. Yet you would never ever know it because I was so high functioning. There’s Going To Be Trauma Continuing to focus on trauma before we look at shame, another common difficulty about working with gay men is that growing up in certain situations, environments and even the media can lead to different degrees of traumatisation. Unfortunately, a lot of these traumas can include being significantly bullied, not being accepted and even being abused by family, being outed to the local community and being beaten. Then you have the religious angles too where a young person’s community, family or religion might reject their homosexuality (and by extension them) completely. The results of this trauma can be devastating. Naturally, any gay man would want to distance himself as much as possible from these painful memories. However, the real problem is for a lot of gay male clients (like I found out) is that you can be as successful and high-functioning as you want but unless you deal with the past, the past will deal with you. That all led to my breakdown in August 2023 because everything just collided together. When this trauma work pops up, a logical first step might be to refer the client to a trauma specialist but if you have a good relationship with the client then this might not be needed. My therapists, both times, weren’t experts in trauma work but they still did a brilliant, life-changing job. There’s Going To Be Shame I’ve met a good amount of gay men in my life as friends and at social events, and I’ve read online even more. I don’t think there is such a thing as a gay man who have never experienced shame because of the homophobia baked into society, and this is a lot more noticeable when the gay man is growing up. Also, this homophobia is very present in the current world and even men who have amazing, accepting and liberal parents, they’ll still experience shame. All because of the world we live in. Especially as we all still live in communities and schools that are filled with people (bigots) that have strong traditional beliefs about how men should behave and if they don’t follow these stupid rules they will be bullied, mocked or beaten. Therefore, there’s a very high chance that your client will feel embarrassed about their past experiences, and they don’t want to stir up their own feelings of humiliation from the past. They’ll be more comfortable avoiding any triggers or memories of these past events, so this leads to shame. But unless the client can work through these past events then they will never heal. On the whole, you should know that gay men are great at hiding their true selves and presenting themselves as something they believe the world would want to see. I understand this feeling because I call myself a survivor and someone who has never lived or thrived or really understands who I am. I am a lot of things from a student, a youngest child, an aspiring clinical psychologist, writer, podcaster, publisher and on and on. But if you had to ask me who I am really, but I have no idea. In my personal email drafts there’s a small message I wrote out for my best friend that describes the effects of my past perfectly and why I have no idea who I actually am and I will actually share it here. It’s interesting and it really captures the extreme ways that gay male clients have to present themselves. I was never allowed to be gay in my childhood, teenage years and most of my young adulthood, so this is the result. For context, me and my best friend had only known each other 3 months and they came round to sleep over for a night. And they were the first gay person and friend my family had ever met before. That's why I wanted them to meet you. The real reason I like you as a friend is because you're just wonderfully you. You can be gay as fuck at times and it's great. You wear feminine and masculine clothes without a second thought and you couldn't give a shit if you look gay. And I love that, because I think that's who I would have liked to have been as a kid. But that kid was slaughtered and murdered and burnt alive a long time ago. That kid had every bone in his body shattered and his screams were stomped out when no one helped him. So he died alone, terrified and murdered. He would have a beautiful kid though. So everything I’ve ever done to is survive because I was so scared and I perceived that I had to present myself in a certain way to prevent anything bad happening. In addition, this idea of presentation and making sure that you fit in can happen in two different ways as well. Firstly, gay men feel like they have to be successful and excel in the professional world so that the professional success and job can hide the feelings of inadequacy that are buried in him because of the bullying, trauma and homophobia. And one error therapists can make here is that because professional success is high then the client’s personal well-being is high too. Secondly, gay men have always stressed physical appearance in the community and the rise of social media has done nothing to stop this trend. This has actually only increased the need for gay men to look perfect, strong and like they’re not experiencing any difficulties at all. As well as they have the idea that there is only one “right” way to look. Ultimately, it’s easy for a straight therapist to be fooled that a gay male client is perfectly fine without any trauma because all they see is this socially accepted version instead of the client’s true self. One way how a therapist can dig past the mask and presentation is to ask about the client’s coming out, who he told about his shame, his experiences of bullying and how he used these experiences to define himself. Then before you reassure him, you might want to stay with the pain and explore how it continues to impact his daily life. In a way you’re exploring how his younger self is different from his current self and sense of expression, so as this conversation goes on you’ll start to see the real him. Help Him Find His Way Towards Healing Pushing away the memory of the trauma to one side is the best way that a lot of gay men have learnt to deal with their mild as well as significant traumas, and they keep moving forward with their lives in hopes that one day it will get better and they’ll live more peacefully. This is typically done by distancing himself from his physical feelings and using disassociation and when your client becomes more involved in the therapy process, it’s natural to ask what he’s feeling on the inside or to use somatic techniques. If the client freezes when asked these questions or if they don’t trust what listening to his body might mean, then this is normal and okay. This is just something you’re going to have to work with him and he’ll open up in time. On the whole, your client needs to trust and be encouraged by you so you can do the healing work with him. And sometimes, there will have to work around his presentation and his body, and your client might feel like his body is betraying him because he might have been perceived by others as more effeminate than other boys or he might have struggled with sports. So the idea that he needs to use his body, listen to it and use somatic techniques (if that’s something you’re doing in therapy) might be terrifying or he might be concerned about being retraumatised. This is why you’re important, because as a therapist you provide a safe space for your clients to use and practice these strategies and techniques and they can draw on their own strength. All leading the client to heal, be delighted that there is hope for a better future and the client might even be grateful for your guidance. If this is the case, then I love the idea of CBT pie charts so you can show the client that therapists give the client the tools and techniques but it is them that actually does most of the work with the therapeutic change needed to improve their lives. Clinical Psychology Conclusion Overall, we’ve covered a lot of great content in today’s podcast episode that will help straight therapists to understand gay male clients a lot more. The lessons from this podcast episode can be boiled down into make sure you trust yourself and your skills to help your client heal, explore how the client consciously as well as unconsciously tries to fit in with their socially accepted presentation and learn the client’s history of being bullied. Honestly, those three things might sound simple and working with gay male clients as I mentioned earlier. As one myself who’s been through therapy twice for homophobia-related trauma and I’ll go to therapy within the next two months (there’s a waiting list) for sexual violence, us gay male clients aren’t anything unique. We certainly aren’t special when it comes to clinical psychology, and we have a lot of the same mental health difficulties and conditions as other people. It is just the reasons, minority stress and the factors we experience that make us different. And being aware is a massive bonus and very helpful in therapy. But as long as you’re kind, accepting and the same amazing therapist that you are with straight clients, you’re going to be great at helping gay male clients. And who knows how many extra lives, you’ll improve, help and maybe save by being accepting. My guess is, a lot more than you ever thought possible. I really hope you enjoyed today’s clinical psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Clinical Psychology: Second Edition. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Clinical Psychology References and Further Reading Alexander, C. J. (2020). Working with gay men and lesbians in private psychotherapy practice. Routledge. Balasubramaniam, H., & Alex, J. (2024). Internalised Homophobia and Interpersonal Relationship: A Systematic Review. International Journal of Indian Psychȯlogy, 12(1). Ellis, A. E., Meade, N. G., & Brown, L. S. (2020). Evidence-based relationship variables when working with affectional and gender minority clients: A systematic review. Practice Innovations, 5(3), 202. Gill, S., & Randhawa, A. (2021). Internalised homophobia and mental health. Indian Journal of Health & Wellbeing, 12(4). Hoy-Ellis, C. P. (2023). Minority stress and mental health: A review of the literature. Journal of Homosexuality, 70(5), 806-830. Malley, M., & Tasker, F. (2020). “The difference that makes a difference”: What matters to lesbians and gay men in psychotherapy. In British Lesbian, Gay, and Bisexual Psychologies (pp. 93-109). Routledge. McConnell, E. A., Janulis, P., Phillips II, G., Truong, R., & Birkett, M. (2018). Multiple minority stress and LGBT community resilience among sexual minority men. Psychology of sexual orientation and gender diversity, 5(1), 1. MONGeLLi, F., Perrone, D., BaLDUcci, J., Sacchetti, A., Ferrari, S., Mattei, G., & Galeazzi, G. M. (2019). Minority stress and mental health among LGBT populations: An update on the evidence. Minerva Psichiatrica, 60(1), 27-50. Ong, C., Tan, R. K. J., Le, D., Tan, A., Tyler, A., Tan, C., ... & Wong, M. L. (2021). Association between sexual orientation acceptance and suicidal ideation, substance use, and internalised homophobia amongst the pink carpet Y cohort study of young gay, bisexual, and queer men in Singapore. BMC public health, 21(1), 971. I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley for a one-time bit of support.

The vast majority of people have heard of Post-Traumatic Stress Disorder (PTSD) before when it comes to veterans and soldiers. Also, we know this mental health condition involves flashbacks, intrusive memories and panic attacks, but beyond that a lot of laypeople don’t know that much about Post-Traumatic Stress Disorder. I’m only starting to learn more about PTSD because I have it because of my sexual assault, so whilst I don’t talk about it in this episode, my own experiences make this important to look at. Therefore, in this clinical psychology podcast episode, we’ll be looking at what is Post-Traumatic Stress Disorder, what causes Post-Traumatic Stress Disorder and what are the symptoms of PTSD. I won’t cover treatments for Post-Traumatic Stress Disorder in this episode because that’s a massive area and I’ve already spoken about that in different episodes on the podcast previously. So if you enjoy learning about mental health, trauma and clinical psychology then this is a great episode for you. Today’s psychology podcast episode has been sponsored by Cognitive Psychology: A Guide To Neuroscience, Neuropsychology and Cognitive Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. What Is Post-Traumatic Stress Disorder? As you can imagine Post-Traumatic Stress Disorder is a mental health condition classed as a trauma and stress-related disorder that can develop in response to being exposed to an event or ordeal where severe physical harm or death was threatened or happened. People can develop PTSD after rape, violence, bombings, shootings, military service and rescue workers can develop PTSD too. In terms of prevalence rate, I talk more about Post-Traumatic Stress Disorder in sexual violence populations briefly in a moment, but about 6.8% of Americans develop the condition in their lifetime. This information is from the National Institute of Mental Health. Furthermore, Post-Traumatic Stress Disorder can develop at any age, including childhood, and women are more likely to develop it than men. Also, there is some evidence that PTSD runs in families, as well as Post-Traumatic Stress Disorder is often comorbid with conditions like depression, anxiety and substance use disorders. Then when these other conditions can be diagnosed and treated, the likelihood of the overall treatment being successful increases. In addition, something we need to know about Post-Traumatic Stress Disorder is you can only get diagnosed with the condition if you have PTSD symptoms for over a month. If you have the symptoms for less than a month then you don’t have PTSD (at least in diagnosis terms), instead you have Acute Distress Disorder. Also, with the right care and support, a lot of PTSD symptoms can abate within trauma survivors within that first month so a lot of people never go on to develop Post-Traumatic Stress Disorder. Interestingly, Post-Traumatic Stress Disorder can be delayed in its manifestations because this occurs if PTSD symptoms show themselves six months or more after the onset of the trauma. Post-Traumatic Stress Disorder And The Military I couldn’t really do a Post-Traumatic Stress Disorder-focused podcast episode without talking about the military as this is where a lot of our common knowledge about PTSD comes from. The prevalence rate of Post-Traumatic Stress Disorder in the military is moderately high because about 30% of the Vietnam War veterans developed PTSD, and 10% of soldiers who took part in Operation Desert Storm (the Gulf War) developed PTSD. As well as between 12% and 20% of soldiers serving in the Iraq war developed PTSD too. As you can imagine, it is the combat element that increases the risk of developing Post-Traumatic Stress Disorder for veterans amongst other mental health conditions, because severe harm and death happens around them. There are other risk factors too, including the politics surrounding the war, the type of enemy the soldier faces and where the war is fought. All these risk factors can interact to cause Post-Traumatic Stress Disorder to develop and be maintained in a soldier. Moreover, there is a type of trauma that is never spoken about in the military and this is Military Sexual Trauma and sexual assault or sexual harassment connects to this topic too. This certainly can cause Post-Traumatic Stress Disorder. Since Military Sexual Trauma can happen to both men and women regardless of whether it’s wartime, peacetime or during training with figures suggesting 23% of women have been sexually assaulted in the US military and 55% of women and 38% of men have been sexually harassed in the military too. Personally, I suspect the real numbers are a lot, lot higher because no one likes to report this stuff and get it on public record. And I say this as a survivor myself, the people that made this research possible are amazing and a lot more courageous than me. Overall, there are a lot of different traumatic experiences that can lead to a person developing Post-Traumatic Stress Disorder. Including terrorist attacks, natural disasters, sexual assaults and physical attacks. Post-Traumatic Stress Disorder And Sexual Violence: Why Am I Talking About PTSD Now? A few weeks ago leading up to Canterbury Pride in early June, I wanted to go by myself to a Warhammer event at my university with a Pride twist. I would be going alone and I wanted to go because it would be nice to meet new people, get back into Warhammer and it would be a good event. Yet I had a lot of social anxiety, I felt physically sick about going and I had seen photos of the Warhammer group at my university and some of the people there were rather triggering for me. A lot popped up that week because of me wanting to go to this event. I was really distressed so I texted my best friend and they mentioned I have PTSD, so I pooed-pooed. I wasn’t listening to them, not that they knew it at the time. Yet I thought about it, researched it a little more and then found out it is very common amongst survivors of sexual violence. This was hammered home last week too when I went to Wales because in the evening, my parents were asleep on the sofa and I was still watching the crime drama that had on and it turned out the killer was getting revenge on her rapists. And the programme showed the implicated rape scenes, so I got really distressed, I couldn’t change the TV over so I shouted and it was a little messy. There are other reasons why I’m certain I have PTSD and I’ll probably sprinkle them in throughout the episode to help show examples of this in real life. Anyway, the reason why I’m talking about Post-Traumatic Stress Disorder now is I want to understand it is more and it is scarily common. For example, Campbell (2009) who looked at studies dating back to the 1980s found that between 17% and 65% of women who experience sexual assault develop PTSD. As well as a peer-reviewed article from the University Of Washington School Of Medicine/Uw Medicine found 81% of survivors had PTSD one week after their attack and 75% of sexual assault survivors had PTSD a month after their attack. Lastly, an article from Verywell Mind in 2023 explained nearly 48% of survivors had PTSD after a year of being assaulted. I want to note that the specific type of Post-Traumatic Stress Disorder that sexual violence survivors develop is known as Rape Trauma Syndrome. So now we understand how common it is in another area besides military veterans, let’s explore the symptoms of Post-Traumatic Stress Disorder in more depth. What Are The Symptoms Of Post-Traumatic Stress Disorder? A lot of people with Post-Traumatic Stress Disorder tend to relive and re-experience the traumatic event or different aspects of it. There is a wide range of triggers, something I am finding out more and more, but there are some common themes. For example, anniversaries of traumatic events and similar people, situations or places can trigger the distressing memories. A similar person example for me was my attacker was very fat and very overweight so I can be extremely triggered when I see a fat man. This isn’t me being fatphobic, it is just fat people trigger my rape memories. In addition, Post-Traumatic Stress Disorder causes a person to experience flashbacks, intrusive thoughts, distributed sleep, anxiety, sadness, intense guilt, emotional numbness, outbursts of anger and dissociative experiences. And whilst people with PTSD try to avoid situations that remind them of the traumatic event, they can still be surprised by what triggers them and when the symptoms last for longer than a month, a diagnosis of PTSD might be relevant. Now I want us to look at the different types of PTSD symptoms. What Are The Avoidance Symptoms Of PTSD? Because no one with Post-Traumatic Stress Disorder wants to be reminded of the traumatic event, we all avoid certain triggers so avoidance symptoms include: ·       Avoiding activities, places and people associated with the event ·       Avoiding conversations, feelings or thoughts about the event As I mentioned earlier, I avoid fat men like the plague because they remind me too much of my rapist, and I avoid any crime drama with a sexual violence theme. Thankfully, I never watched Law and Order: Special Victims Unit. What Are The Reexperiencing Symptoms Of Post-Traumatic Stress Disorder? When it comes to the reliving the traumatic experience over and over again, symptoms include: ·       Experiencing intense emotions when you’re reminded of the event ·       Feeling or behaving as if the event was actually happening all over again (flashbacks) ·       Having distressing memories and bad dreams of the event ·       Having dissociative reactions and/ or loss of awareness of your present surroundings ·       Having intense physical sensations when reminded of the event. Such as, feeling faint, feeling a loss of control, sweating, pounding heart and so on. One of the ways I’ve experienced these symptoms include very distressing physical sensations all over my body about how he was touching and doing things to me, and that’s all I’ll say about that one. As well as I used to have this one a lot more but it has thankfully mellowed out a little nowadays, I would have a complete loss of awareness that worked with these physical sensations so I would need to use grounding techniques to get me to focus back on the present. What Are The Reactivity and Arousal Symptoms Of PTSD? When it comes to the reactivity and arousal symptoms of Post-Traumatic Stress Disorder, they can include: ·       Feeling easily startled. ·       Excess awareness (also known as hypervigilance) ·       Sleeping difficulties including having trouble falling or staying asleep ·       Difficulty concentrating ·       Outbursts of anger or being irritable An unfortunately good example of this area for me was during my Statistic Theory online exam in May. Since it was bad enough that I couldn’t concentrate enough to do any revision whatsoever until a week before the exam, as well as because the exam was online and made up of 40 multiple choices, my mind wondered after question 20. Which led to a full-on meltdown and panic attack during my exam. That wasn’t nice but thankfully I passed, only by 3 points by still. What About The Mood and Cognitive Symptoms Of Post-Traumatic Stress Disorder? When someone has PTSD, they’ll experience negative changes in their mood and thoughts, these symptoms can include: ·       An inability to experience positive moods ·       A lack of interest in social activities ·       Feeling detached and numb from things ·       Having difficulty remembering an important part of the traumatic event ·       Pessimism about the future In terms of clinical psychology, one thing I do want to mentiom is you can see why depression and anxiety are common conditions to find alongside PTSD. For example, a lack of interest in social activities and pessimism about the future, they’re both common with depression too. Going back to personal experience, I’ve already mentioned the social anxiety I have about going to something new and I have basically stopped that now, and even social events I’ve been going to since before my assault. It still takes me a while to actually go to them before I do. For example, I am not that ashamed to admit, I spent twenty minutes in the university toilets with my social anxiety before I went to a social last week. Are There Other Symptoms Of Post-Traumatic Stress Disorder? Some other symptoms of PTSD that don’t really fit into the other categories include: ·       Depersonalisation- feeling like you’re outside of your body ·       Derealisation- experiencing unreality of surroundings These symptoms are rarer for people but some clients can experience them. What Causes Post-Traumatic Stress Disorder? Whilst we don’t know the definitive cause of Post-Traumatic Stress Disorder, we know that there are biological, psychological and social factors that interact together to develop the condition. Since Post-Traumatic Stress Disorder causes changes in how the body responds to stress so it impacts our stress hormones as well as neurotransmitters that carry information between our nerves. As a result, people who experience childhood abuse or other traumatic experiences are likely to develop PTSD months or even years after the trauma. Also, temperamental variables, like externalising behaviours or other anxiety difficulties, can increase the risk of developing the condition too. Additionally, environmental factors can cause PTSD. For instance, childhood adversity, family dysfunction, family mental health history, cultural variables, and more importantly, the more traumatic the event, the greater the risk of developing Post-Traumatic Stress Disorder. This is why witnessing atrocities and severe personal injury are major, major risk factors. Moreover, having maladaptive coping mechanisms, a lack of social support, financial stress and family instability can all worsen the mental health outcomes for people with Post-Traumatic Stress Disorder. Personally, because my best friend is the only social support I actually have since my sexual assault because other people just don’t know how to help me and the most important people in my life just want to pretend it never happened and I am perfectly fine. I am seriously not. That can decrease my mental health a lot because I feel guilt towards my best friend because they are all I’ve got until my specialise counselling starts and my best friend isn’t always around, so I have had to do some maladaptive coping mechanisms just to survive. Having more social support is critical when it comes to PTSD. On the other hand, there are resilience factors that can decrease the risk of a client developing Post-Traumatic Stress Disorder. Some of these resilience factors are present before the trauma and other resilience factors can become more importantly learnt during and after the traumatic event. For example, seeking out support including mental health professionals, finding a support group, feeling good about your own actions in the face of danger, being able to act and respond effectively despite fear and having a coping strategy are all resilience factors that can help reduce the development of Post-Traumatic Stress Disorder. Clinical Psychology Conclusion We’ve covered a lot of ground when it comes to Post-Traumatic Stress Disorder because we’ve looked at what is PTSD, how common is PTSD in the military and sexual violence survivors, what are the symptoms and what are the causes. After this episode, we’ve all deepened our knowledge about this mental health condition a lot and I’m pleased that we’ve all learnt about PTSD more. Since PTSD is a horrible, horrible condition to have but there is hope. There are treatments and you can still live a long, happy life with the condition. Even though I’ve been having panic attacks, distressing memories, distressing physical experiences and so on, there are still happy, joyful moments. Like I love spending time with my best friend, I enjoy Outreach work at my university and I still love writing. There are moments of positivity so I focus on them. And another reason why I liked today’s episode is that I could start to see what I’m experiencing is normal and it’s a natural response to an extremely unnatural situation. I am not a problem and no one with PTSD is a problem. Therefore, I want to conclude this episode by saying that if you ever meet, become friends with or get to know someone with PTSD. Offering them some social support (that accurately reflects the level of friendship of course), listening to them and signposting them to some mental health services could have a massive positive impact on that person. And it really could change their life for the better. I really hope you enjoyed today’s clinical psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Cognitive Psychology: A Guide To Neuroscience, Neuropsychology and Cognitive Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Clinical Psychology References and Further Reading American Journal of Psychiatry Annual Review of Psychology Au, T. M., Dickstein, B. D., Comer, J. S., Salters-Pedneault, K., & Litz, B. T. (2013). Co-occurring posttraumatic stress and depression symptoms after sexual assault: A latent profile analysis. Journal of affective disorders, 149(1-3), 209-216. Biological Psychiatry Brown, A. L., Testa, M., & Messman-Moore, T. L. (2009). Psychological consequences of sexual victimization resulting from force, incapacitation, or verbal coercion. Violence against women, 15(8), 898-919. Campbell, R. (2009). Trauma, Violence, & Abuse, Vol. 10, No. 3. Canadian Journal of Psychiatry Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Dworkin, E. R., Menon, S. V., Bystrynski, J., & Allen, N. E. (2017). Sexual assault victimization and psychopathology: A review and meta-analysis. Clinical psychology review, 56, 65-81. Hippocampal Volume in Women Victimized by Childhood Sexual Abuse. https://www.eurekalert.org/news-releases/630084 https://www.psychologytoday.com/us/conditions/post-traumatic-stress-disorder https://www.verywellmind.com/symptoms-of-ptsd-after-a-rape-2797203#toc-symptoms-of-ptsd-after-sexual-assault Journal of Psychopharmacology Journal of Traumatic Stress Mohammed, G. F., & Hashish, R. K. (2015). Sexual violence against females and its impact on their sexual function. Egyptian Journal of Forensic Sciences, 5(3), 96-102. National Center for PTSD, U.S. Department of Veterans Affairs National Comorbidity Survey Replication National Institute of Mental Health National Institutes of Health - National Library of Medicine O’Callaghan, E., Shepp, V., Ullman, S. E., & Kirkner, A. (2019). Navigating sex and sexuality after sexual assault: A qualitative study of survivors and informal support providers. The Journal of Sex Research, 56(8), 1045-1057. Panisch, L. S., & Tam, L. M. (2020). The role of trauma and mental health in the treatment of chronic pelvic pain: a systematic review of the intervention literature. Trauma, Violence, & Abuse, 21(5), 1029-1043. Psychiatric Clinics of North America US Department of Health and Human Services I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley for a one-time bit of support.

With the university year ending and many students returning home for the summer to see their families, catch up with old friends and live in cheaper (or even free) accommodation, this is a time of year that is both great and difficult for LGBT+ people. If you or your client are closeted or if your family is homophobic then returning home can be difficult and decreases your mental health. This isn’t good. Therefore, today’s psychology podcast episode focuses on how to navigate going home as an LGBT+ person, including why this is difficult and what to do about it. Whether you’re LGBT+ or not, this is still a useful episode you can learn from. If you enjoy learning about LGBT+ experiences, social psychology and mental health then this is a great episode for you. Today’s psychology podcast episode has been sponsored by Working With Children and Young People: A Guide To Clinical Psychology, Mental Health and Psychotherapy. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Note: as always nothing on this podcast is any sort of official advice whatsoever. Why Can Going Home Be Difficult For LGBT+ People? Traditionally, the idea of going home and being surrounded by family after a term or academic year away is joyful, fun and it is the sign that you finished another great year at university. You’re one step closer to graduating and after all your hard work this year, you can now relax with your family and friends over the summer months. However, whether it’s the end of an academic year, going home for the holiday season or even going home after spending a lovely day with an accepting friend, going home can always be difficult for LGBT+ individuals. There’s a range of reasons why this could be the case. A lot of LGBT+ people have a complicated relationship with their family and parents and the same goes for hometowns to be honest. Since hometowns and the places we grew up in can represent the bullying, the homophobia and the abuse we faced in our younger years. A lot of young LGBT+ people experience trauma and oppression in their hometowns and at the hands of their families, so going back to them is always a difficult affair. Another way to look at this is we consider how our own families or hometowns tend to be the places where young LGBT+ people are most othered and made to feel like strangers, weirdos and freaks. No one ever wants to return to places or people that make us better like these horrible things. Personally, I’ve mentioned before how homophobic my upbringing was and how it led to trauma and child abuse and everything I’ve already explained on the podcast. And I’ve always classed myself as a survivor and I didn’t really have any other option but to stick with this undesirable outcome. It would have been nice not to have to live in this day in and day out but that was my life for over a decade, it seriously killed my mental health over time. However, linking to this topic, when I was going through emotional dependency last August, I remember leaning on my super-accepting friend who was also gay, and I just cried. Because after spending such a lovely day with him, I did not want to return home, so it is really, really difficult to go home at times as an LGBT if you’re “social environment” does not like, respect or tolerate you. Thankfully, everything is a million times better now but still, in the past it was not. In addition, these feelings of shame and other negative emotions and triggers can be brought to the forefront of our minds if we have to share a space or go to a physical location that we associated with abuse, hate or homophobia during the holiday season or summer months. For example, if we have to spend time with extremely homophobic people and we might be really anxious about how this will go and what abuse we will have to hear, and this is still bad for us to experience even if we’re closeted to these people. Sometimes for our own safety. I remember having to go to a party at one of my brother’s friends’ houses and I was stuck listening to their homophobic “banter” for hours. It was hurtful, awful and I didn’t want to be listening to this utter rubbish about how disgusting and an abomination I was. Now none of this was directed at me personally but it was still directed at who I was and who I loved, so I hated my brother and his friends that night. It was difficult to say the least and now I seriously put my foot down and I refuse to go to anything related to my brother’s friends. If my brother and his family want picking up, they can find their own way back. I am flat out not getting stuck at a party again waiting for my brother and his family to get ready for three hours. Overall, home will always be complicated for LGBT+ individuals. Even more so when we consider that going home and returning to our hometown evokes a lot of emotions about our younger selves and how we never felt like we belonged growing up. This comes with a lot of fear, pain and depression and some people want to hide or run away. Additionally, going off on a quick minor tangent here, this is what happens to me whenever my best friend talks about their past relationships and the one they’re currently in. I let them talk about it, because they’re my friend and we’re really close. But it always evokes pain, sadness and grief inside me because they’ve always been able to live a gay life that I was never allowed to live. A life that’s even harder to get now because of my sexual assault. I understand that drive to hide because if you can’t be seen then you can’t be attacked or hurt or shouted at. Nonetheless, there is one thing to remember here. There is an opportunity in going home and returning to your hometown because you can get through the summer and holiday season. Yet you can find healing too, and we can heal our younger selves as well. This can all be done by focusing on taking care of ourselves and our younger LGBT+ selves. I know this sounds a little woo-woo at the moment but please, bear with me. How Can Exploring Emotional Care Towards Our Younger Queer Selves Help Us Navigate Going Home? Last year, I did one of my favourite podcast episodes about how LGBT+ individuals effectively have a second adolescence where they can reclaim and have the experiences they were robbed of during their first or “biological” adolescence. Like, a first date, kissing, relationships and so on. The reason why a second adolescence is needed in the first place is because the vast majority of LGBT+ people hold wounds within our younger selves and these wounds need to be addressed. Once these are addressed, we can begin healing, living and enjoying life, something that was effectively stolen from us as teenagers. As a result, this second adolescence gives us an opportunity to explore what emotional needs our younger selves have when we return home to our families or our hometown. You might need to consider allowing yourself to grieve for the life and childhood that was stolen from your younger self as well as you might want to stand up for your younger self. For example, if you hear homophobia or if you see anyone who used to bully or abuse you, if you’re safe now then you might want to challenge them so you can stand up for your younger self. In addition, you might need to tell your younger self that you’re safe now and you aren’t being abused, beaten or anything that your younger self went through or was scared to go through. As well as you might need to validate and empathise with your younger self. For instance, if your younger self would be scared to go back to a physical location or see certain people again then tell your younger self that that is okay and it’s normal to feel uncomfortable. Ultimately, this is all about being kind to yourself when you return to family and hometowns during the summer, holiday season or anywhere else. In my experience, I always have to allow my younger self to grieve as I mentioned earlier when my best friend talks about their relationships. Since that was a life that was just way too dangerous for me and it was awful and even though I am safe now and in a better position, having to unlearn all that abuse and anti-gay messaging is hard. As well as when I was in therapy last year for this abuse, my therapist wanted me to write a letter to my younger self to help him heal and everything so he would know I was safe now. It really did work and I do recommend that idea. Just be kind to yourself, look after the emotional needs of your current self and your younger self, and respect your emotional needs. Explore The Boundaries You Need Moving onto our current selves, whenever we return home to our families or our hometown, we need to think about the emotional as well as physical boundaries we need to get in place so we feel safe, comfortable and like we have our own space. These boundaries can include attending certain events but not others, seeing certain people but not other people and deciding what we want to share about our lives and what we really don’t want to share. Moreover, you can set boundaries on the amount of time you want to spend with certain people and at certain events. As well as you need to find ways to make sure these boundaries are respected by you and other people, even if our family or others don’t want us to respect our boundaries. You have to give yourself permission to set these boundaries and protect yourself. This is something I was extremely bad at because I just wanted to survive in my hometown, but there was one boundary I did set. I barely told my “social environment” anything about my life and anything gay-related that I was doing. For example, I remember going to Margate Pride in August 2023 with some friends but I didn’t tell other people about that, I said I was going to Broadstairs, a little seaside town instead. I also never told other people that I had gay friends and I never told them about the Mythbuster work I was doing with my university and so on. I kept boundaries to protect myself and make my life so much easier. You need to do the same. Social Psychology Conclusion Before I finish off this podcast episode focusing on LGBT+ listeners, I wanted to focus on everyone else including our aspiring or qualified clinical psychologists. I always hope these sort of podcast episodes are really useful, even if you’re not LGBT+ yourself. Since all of us need to learn, listen and respect the lived experiences of other people and chances are you will meet an LGBT+ client in the future, so having a basic understanding of the social and familial issues that LGBT+ clients go through will help to make you a better therapist than someone who has never learnt this stuff. So thank you for listening and reading. In addition, LGBT+ people will have complicated relationships with their families and hometowns because of homophobia, transphobia and all the anti-LGBT+ messaging that we face on a daily basis. If you have a great relationship with your family then more power to you, and I am really happy for you. Yet other people do not have that, so if you’re returning home to your family or hometown after another university year or during the holiday season. This can be hard, especially if you’ve been living a free and authentic life being your wonderfully queer self at university, to have to come home and closet yourself again. That is hard. Therefore, you need to look after yourself, set and respect boundaries and look after the emotional health of your younger self too. Ultimately, going home might seem hard and impossible, but it is more than possible to find a place where you and your younger self are safe, secure and comfortable during this summer or holiday season. I really hope you enjoyed today’s social psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Working With Children and Young People: A Guide To Clinical Psychology, Mental Health and Psychotherapy. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Social Psychology References and Further Reading Donovan, C., Magić, J., & West, S. (2023). Family abuse targeting queer family members: An argument to address problems of visibility in local services and civic life. Journal of Family Violence, 1-13. https://www.psychologytoday.com/gb/blog/second-adolescence/202312/navigating-holidays-and-hometowns-as-an-lgbtq-person Jonas, L., Salazar de Pablo, G., Shum, M., Nosarti, C., Abbott, C., & Vaquerizo‐Serrano, J. (2022). A systematic review and meta‐analysis investigating the impact of childhood adversities on the mental health of LGBT+ youth. JCPP advances, 2(2), e12079. Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT young adults. Journal of child and adolescent psychiatric nursing, 23(4), 205-213. Strauss, P., Cook, A., Winter, S., Watson, V., Wright Toussaint, D., & Lin, A. (2020). Mental health issues and complex experiences of abuse among trans and gender diverse young people: Findings from Trans Pathways. LGBT health, 7(3), 128-136. Westwood, S. (2019). Abuse and older lesbian, gay bisexual, and trans (LGBT) people: a commentary and research agenda. Journal of elder abuse & neglect, 31(2), 97-114. Wilson, C., & Cariola, L. A. (2020). LGBTQI+ youth and mental health: A systematic review of qualitative research. Adolescent Research Review, 5(2), 187-211. I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley for a one-time bit of support.

There are countless numbers of cases where someone with a mental health condition has been abused by the police or other law enforcement professionals. This is wrong, dangerous and many of these cases end up with the person with the mental health condition being killed or dead. Therefore, in this forensic psychology podcast episode, we’ll look at why are people with mental health conditions more likely to be abused by police, what are the factors behind this abuse and if there is anything we can do to prevent police abuse. If you enjoy learning about forensic psychology, mental health and clinical psychology, then this is a great episode for you. Today’s psychology podcast episode has been sponsored by Police Psychology: The Forensic Psychology Guide To Police Behaviour. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Examples Of Where People With Mental Health Conditions Have Been Abused As the top two countries for listeners are the United States and the United Kingdom, I want to take an example from both countries to show why we seriously need to talk about this pressing issue. Firstly, in the United States, an African American man called Jordan Neely was having a psychotic episode in the New York subway so a passenger strangled him to death to quiet down his psychotic episode. Secondly, in the United Kingdom, independent scholar Saville-Smith who wrote about madness was wrestled into submission by police officers who cracked his ribs, gave him abrasions all over his arm and gave him nerve damage to his fingers. Then after this situation with the two police officers he was involuntarily hospitalised. This was all started because his wife was worried about him so she called a doctor and the doctor called the police, and Saville-Smith told the officers he didn’t want to be locked up because his own environment was safe for him and he knew how everything worked. These situations where people with mental health conditions have violent interactions with the police are no secret, they’re common and this is just common knowledge at this point unfortunately. As well as anyone who experiences psychosis understands that they could be locked up and physically attacked if anything happened in public. Furthermore, both of these cases that happened on different sides of the Atlantic Ocean involved a violent altercation that got worse, possibly because of intersectional forces. Since Saville-Smith was an older adult and Neely was black. Whilst I’m trying to keep this podcast episode very focused on the issue of the police beating and killing people with serious mental health conditions, I’m realising the more I write about this topic the more additional topics it connects to. For example, you could argue this very much connects to mental health stigma and misconceptions because the majority of people believe individuals with psychosis are crazy, dangerous monsters that are a threat to people. That isn’t true. Also, this could connect to racial profiling and the stupid idea that black people are more dangerous or more criminal than white people. No social group is more criminal than the other. Those With Mental Health Conditions Being Overrepresented In The Prison Population In addition, it’s concerning how people with mental health conditions are overrepresented in the prison population. For example between 2010 and 2013 in the state of New York, over 600,000 people were arrested and matched by public health records to have a serious mental health condition in the 12 months before they were arrested. For New York during this time period, that means between 4% and 6% of the state’s prison population had a mental health condition. This is over presentation because you cannot tell me that between 4% and 6% of the entire population of New York State has a serious mental health condition, like psychosis. And what’s even more concerning is that this number was associated with a 50% increase in the chance of these people being sentenced for misdemeanour arrests. Granted, it is good that having a mental health condition wasn’t associated with an increased chance of being charged with criminal offences. Moreover, this number increases when we consider the world’s population because about 40% of people in prison could have a mental health condition according to work published in World Social Psychiatry. For example, people with psychotic disorders are between 2 and 16 times more likely, and people with depression are between two and six times more likely to develop in prison populations. Whenever I write about forensic psychology, I always find this overrepresentation both interesting and rather heartbreaking. Since it doesn’t matter the overrepresentation comes from those with mental health conditions, different racial backgrounds or different socioeconomic backgrounds. These all reflect different flaws, biases and systemic problems engrained into the Criminal Justice System. Of course those topics are beyond the scope of this podcast episode but I’m just trying to highlight additional topics or factors you might want to think about. People With Mental Health Conditions Being Abused By Police A 2018 study (reference at the bottom of the podcast episode) showed that 23% of people in 2015 who were killed by police during an altercation had a serious mental health condition. As well as the likelihood of them being killed was increased by factors like having a mental health condition and race. Also, people with a mental health condition were more likely to be killed in their own home. Nonetheless, it’s important that we don’t fool ourselves into thinking that even the prison system itself is safe for people with mental health conditions. Since yes, people with serious mental health conditions are attacked and killed in public and at home, but it isn’t the only place they’re abused and killed. The prison system itself can lead people with severe schizophrenia to be abused and neglected. An unfortunate example of this was Tammie Davenport who helped her son who had schizophrenia after she found out he was being abused in the Chatham County Jail where the jail couldn’t make medical decisions for him whilst he was in prison, and it led to a year-long quest for her to help her son. Thankfully, he’s doing better now according to the Facebook group, Justice for Justin. In addition, the Valdosta Daily Times did a news article in 2022 where an inmate died within three months of being kept in the same jail as Tammie Davenport’s son because the jail staff denied medical care to him when he seemed to be suffering from cardiomyopathy. As well as the Senate Permanent Subcommittee in the USA had 20 hearings about nearly 1,000 different deaths that were unreported by the Department of Justice in 2021. Leading some to suggest that the constitutional rights of inmates aren’t being protected. Personally, I just think this is all disgusting and outrageous. We all know and we have the empirical research that time and time again shows that rehabilitation works to reduce reoffending, and yes I understand there is not the political will needed in most areas to invest in rehabilitation. Since guess what, sounding tough on crime with long, pointless prison sentences that do nothing to decrease reoffending and criminal behaviour, sounds better to voters and it wins elections. If we do not support offenders, give them skills they need to effectively turn over a new leaf and if we don’t support their mental health then society will suffer in the long term as we need to keep wasting money on trials, investigations and sentencing because the cycle of criminality continues. The only way to stop the cycle is by rehabilitating offenders and not killing or beating or abusing them in prison. No one should ever be abused. There is never an excuse for it. Forensic Psychology Conclusion On the whole, the topic of police injustice is a major topic all over the world, and it is a topic that seriously needs reform. There needs to be some kind of training and scheme that helps social workers and mental health professionals to work with law enforcement during dispatch calls so these mental health professionals can help mitigate the extreme effects that happen when people with serious mental health conditions and law enforcement cross paths. Overall, I hope over time different programmes will be developed, implemented and the rights of inmates will be protected. Since just because someone has a serious mental health condition, it doesn’t mean they deserve to die, be beaten or have their ribs broken. That is outrageous and unacceptable and it needs to stop immediately. You could argue that people with serious mental health conditions represent so-called “risks” to the public, but I seriously doubt that is true. That is why mental health professionals need to be deployed so they can help law enforcement so killing and beating innocent people who are going through extremely scary mental health experiences can stop. I always say the job of clinical psychology is to improve lives, decrease psychological distress and give clients more adaptive ways of coping. Now in this situation, I want to add another critical point. The job of clinical psychology is to save lives and make sure more people don’t end up dead. I really hope you enjoyed today’s forensic psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Police Psychology: The Forensic Psychology Guide To Police Behaviour. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Forensic Psychology References and Further Reading Ashley, Asia. (2022). "Senate eyes unreported prison deaths." Valdosta Daily Times. Borum, R., Swanson, J., Swartz, M., & Hiday, V. (1997). Substance abuse, violent behavior, and police encounters among persons with severe mental disorder. Journal of Contemporary Criminal Justice, 13(3), 236-250. Dorn, T., Ceelen, M., Buster, M., Stirbu, I., Donker, G., & Das, K. (2014). Mental health and health-care use of detainees in police custody. Journal of Forensic and Legal Medicine, 26, 24-28. Hails, J., & Borum, R. (2003). Police training and specialized approaches to respond to people with mental illnesses. Crime & delinquency, 49(1), 52-61. Hall, D., Lee, L. W., Manseau, M. W., Pope, L., Watson, A. C., & Compton, M. T. (2019). Major mental illness as a risk factor for incarceration. Psychiatric services, 70(12), 1088-1093. https://www.psychologytoday.com/us/blog/living-as-an-outlier/202306/people-with-mental-illness-more-likely-abused-by-law-enforcement Jackson, A. N., Butler-Barnes, S. T., Stafford, J. D., Robinson, H., & Allen, P. C. (2020). “Can I live”: Black American adolescent boys’ reports of police abuse and the role of religiosity on mental health. International journal of environmental research and public health, 17(12), 4330. Lurigio, A. J., & Watson, A. C. (2010). The police and people with mental illness: New approaches to a longstanding problem. Journal of Police Crisis Negotiations, 10(1-2), 3-14. Morabito, M. S. (2007). Horizons of context: Understanding the police decision to arrest people with mental illness. Psychiatric services, 58(12), 1582-1587. Saleh, A. Z., Appelbaum, P. S., Liu, X., Stroup, T. S., & Wall, M. (2018). Deaths of people with mental illness during interactions with law enforcement. International journal of law and psychiatry, 58, 110-116. Seo, C., Kim, B., & Kruis, N. E. (2021). Variation across police response models for handling encounters with people with mental illnesses: A systematic review and meta-analysis. Journal of criminal justice, 72, 101752. Varadarajulu, R. N., & Mahapatra, A. (2023). Prison mental health in the United States of America and India: A Dual perspective. World Social Psychiatry, 5(1), 42. I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley for a one-time bit of support.

Continuing our celebration of Pride Month here on the podcast, I want to look at the benefits of gender-affirming care on transgender youth. Since gender-affirming care saves lives, it improves mental health and it decreases gender dysphoria and the associated negative mental health outcomes. However, one debate that is raging across the world is whether underage transgender youth should be allowed to undergo gender-affirming care if they’re going through a mental health crisis. A crisis that could led to suicide. In this clinical psychology podcast episode, we’ll look at why denying youth gender-affirming care could increase suicide, what we can do to help transgender youth and ultimately why giving youth a way of their gender dysphoria with gender-affirming care could save lives. If you enjoy learning about mental health, gender dysphoria and clinical psychology then this is a great episode for you. Today’s psychology podcast episode has been sponsored by Working With Children and Young People: A Guide To Clinical Psychology, Mental Health and Psychotherapy. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Some Basic Facts About Transgender Individuals and Gender Dysphoria I wanted to kick off this podcast episode by focusing on some facts about transgender individuals and gender dysphoria based on findings from research studies so we all understand what is actually happening. Since I know no one really investigates the truth about transgender people on their own and a lot of people rely on negative, biased media reports for their information. I used to be the same. Therefore, according to Anderson et al. (2023), there are nearly 1.4 million Americans that have gender dysphoria, meaning they do not identify with the sex they were assigned at birth. As well as Parker et al. (2022) found that 64% of Americans support transgender people against discrimination. In addition, below is an extract from an introduction I wrote for an academic paper where I was talking about the negative impact of gender dysphoria on mental health: “Half of all transgender youth report a history of suicidal ideation (James et al., 2016) and low self-esteem (MacCarthy et al., 2015) emphasising the need for mental health support for this clinical population. Also, research suggests gender dysphoria is an additional major cause of this mental health disparity. Gender Dysphoria refers to the psychological distress associated with the gender incongruence between the individual’s gender assigned at birth and their gender identity (APA, 2013) and Gender Dysphoria is associated with depression, suicidality, anxiety and eating disorders (Petersen et al., 2017) due to the profound emotional and physical suffering the dysphoria causes an individual (Morris & Galupo, 2019).” As a result, you can see how gender dysphoria leads to an increase in stark and dangerous mental health outcomes. This is why gender-affirming care is so important and why it saves lives. Below is another extract from my draft introduction that explains why gender-affirming care is so important, useful and valuable in saving lives: “Gender-affirming practices aim to reduce the psychological stress caused by gender dysphoria (Keo-Meier et al., 2015; Olson et al., 2016). For instance, trans-masculine participants experienced improved mental health and quality of life after receiving top surgery (Poudrier et al., 2019) and testosterone (Keo-Meier et al., 2015). Also, gender-affirming practices help participants to experience significantly lower rates of psychological distress and suicidal ideation compared to transgender individuals not undergoing gender-affirming practices (Almazan & Keuroghlian, 2021) with similar findings being found by additional studies (Sansfcon et al., 2020; Swan et al., 2021). Due to gender-affirming practices aid participants in living authentically through the process of social transitioning. Social transitioning refers to the process where transgender individuals express themselves in a way that reflects their gender identity to the outside world (Austin et al., 2022). Typically, this process involves changing their clothing, hairstyle, accessories to reflect their internal state of Self more accurately amongst other practices (Austin et al., 2022). Social transitioning has a history in psychological literature demonstrating its profound positive impact on transgender individuals through qualitative studies (Austin & Craig, 2015). For instance, using a transgender individual’s chosen pronouns and name in multiple domains of functioning (like school, home and the workplace) caused decreased suicidal ideation by 65% and depression by 71% (Russell et al., 2018). Further, socially transitioned transgender youth who were supported in their gender identity were found to have only minimally increased anxiety levels and developmentally normative levels of depression, suggesting mental health difficulties can be avoided in this population (Olson et al., 2016). Consequently, research demonstrates gender-affirming practices, including social transitioning, are critical to reducing the psychological distress and severe negative mental health outcomes caused by gender dysphoria.” Furthermore, Parker et al. (2022) found that Americans were seriously split over whether to allow gender-affirming surgery at all for anyone. Americans were generally undecided about whether to allow adults to have a surgery, but most Americans were flat out against allowing children under 18 to surgically change their gender. I know there are a lot of reasons why people feel like this and I acknowledge the majority of the time these reasons are coming from a good place, but in reality, a lot of the arguments don’t hold that much water. Especially when we investigate the mental health angle and how a gender-affirming surgery can be the difference between a child committing suicide or living. Should Transgender Youth Have The Right To Determine Their Gender? The first argument I’ve heard way too much about is the idea that children are too young to understand the consequences of any medical decision. Due to if we think about changing your pronouns that is very easy to reverse, you can’t reverse surgery. As well as Jackson (2023) found that some transgender youth still commit suicide even after gender-affirming treatment. However, we still need to remember that these children are going through the psychological distress that gender dysphoria causes because their post-puberty state does not match their internal reflection of their gender. This dysphoria is extremely distressing and self-harm is very, very possible and so is suicide if we stop a child from getting any form of help because we apparently know better. For the sake of improving the mental health of transgender youth, they deserve the right to choose their own gender. As a result, transgender youth are in a mental health crisis (Marcia, 2006) caused by the extreme distress of there being an incongruent between their external and internal reflection of their gender. Then we need to acknowledge that if there is a failure to overcome their childhood crisis then this can be fatal or disastrous (Jennings, 2015), also if children are asking for the right to choose their own gender then it isn’t because it’s trendy, it’s a craze or it’s a fad. It's because they don’t have it already. Adults already have the right to choose their own gender, so why don’t children have the same right? This is ultimately an equality question, because I have no idea what children will have to do to be treated equally to adults. Americans and everyone all over the world have already been asking for the right to choose by people assigned female at birth (let me think this is when women were asking for the right to vote so they could be treated equally by men) and people assigned black at birth (black people wanted to be treated equally). And before women and black people gained more equal rights, they were treated like children. Women weren’t allowed to work, they weren’t allowed to vote because they were deemed by men to be too dim to understand politics and they weren’t allowed the freedom to do whatever they wanted with their lives. All minorities are treated as children before they gain equal rights. Everyone should have the right to choose about their own life so children would be no exceptions. This already happens in other ways, like we allow children to dye their hair, get their haircuts, go wherever they want with their friends, and more. Let’s extend this right to choose to the really important things that ultimately save lives. And there is a brilliant and rather heartbreaking comment I’ve seen that I think is so true. Remembering that minors cannot vote, it is all well and good that we spent our time debating and arguing about what minors need to be safe, secure and protected. At the same time, these minors are in chatrooms and planning and discussing the advantages of secret suicide (Jennings, 2015; Marcia, 2006). This is not okay and we need to do something about this. The easiest and most effective way to decrease these secret suicide discussions is to simply allow children to choose their own gender, and implement both the social and possibly medical methods of gender-affirming care. Why The Agony Of Transgender Youth Matters As aspiring and qualified psychologists, it is our job to get children out of a mental health crisis and into a safe place, so children can survive. We always put the psychological needs of our client before ourselves because our client is the most important person, and we need to help them. Whatever a client is going through that is important to us as psychologists, we need to make sure we help them, so they can go through to live a full, happy and productive life. Their agony and distress matter to us. Also, whenever we’re with clients, we never invalidate them. We never tell someone with depression that they aren’t depressed because we don’t feel depression, or their depression isn’t valid because it’s unusual or uncommon in our culture. We never do that because that doesn’t help our clients and it certainly doesn’t help decrease their psychological distress. So let’s never do that to transgender youth either. Clinical Psychology Conclusion At the end of the day, as adults, we need to realise that when a child is telling us they’re undergoing gender dysphoria and they’re extremely distress, we need to treat this as fact. The child isn’t lying and if we don’t listen to them then this could have horrific consequences. Since for transgender youth, they are undergoing a mental health crisis and unless they get support and acceptance and some form of gender-affirming care, social transitioning is still a brilliant range. Then you can think of this as a glass bottle that is getting more and more pressurised. And at some point the glass bottle will shatter, the child will have a breakdown and they might commit suicide. We cannot allow that to happen. You can argue as much as you want about whether gender-affirming care is moral or ethical for children, but your arguments do nothing to help a grieving mother or father of a dead child. So the takeaway from this episode is don’t close every door on a child’s hope for acceptance. Because if you do that, there will only be a single door left open for the child to take and when they go through that door, they will not return, they will not feel like they have another choice and they will not be alive. Death, suicide and pain is all that remains when we take away gender-affirming care. I really hope you enjoyed today’s clinical psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Working With Children and Young People: A Guide To Clinical Psychology, Mental Health and Psychotherapy. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Clinical Psychology References and Further Reading Almazan, A. N., & Keuroghlian, A. S. (2021). Association between gender-affirming surgeries and mental health outcomes. JAMA surgery, 156(7), 611-618. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. Anderson, D., Wijetunge, H., Moore, P., Provenzano, D., Li, N., Hasoon, J., Viswanath, O., Kaye, A. D., Urits, I. (2023). Gender dysphoria and its non-surgical and surgical treatments. Health Psychology Research, 10(3). doi:10.52965/001c.38358 Austin, A., & Craig, S. L. (2015). Transgender affirmative cognitive behavioral therapy: Clinical considerations and applications. Professional Psychology: Research and Practice, 46(1), 21. Austin, A., Papciak, R., & Lovins, L. (2022). Gender euphoria: A grounded theory exploration of experiencing gender affirmation. Psychology & Sexuality, 13(5), 1406-1426. Cummings Center for the History of Psychology (1957). Richard Evans interviews Carl Jung - Personality, organization, fundamental concepts [video]. Available at: https://www.youtube.com/watch?v=tLeXXoumkqU Jackson, D. (2023). Suicide-related outcomes following gender-affirming treatment: A review. Cureus, 15(3). doi:10.7759/cureus.36425 James, S., Herman, J., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. A. (2016). The report of the 2015 US transgender survey. Jennings, K. (2015, October). Leelah Alcorn and the continued struggle for equity for LGBT students. In The Educational Forum (Vol. 79, No. 4, pp. 343-346). Routledge. Keo-Meier, C. L., Herman, L. I., Reisner, S. L., Pardo, S. T., Sharp, C., & Babcock, J. C. (2015). Testosterone treatment and MMPI–2 improvement in transgender men: A prospective controlled study. Journal of consulting and clinical psychology, 83(1), 143. Marcia, J. E. (2006). Ego identity and personality disorders. Journal of Personality Disorders, 20(6), 577-596. Meinecke, L. D. (2017). Neglected by assessment: Industry versus inferiority in the competition for scarce kidneys. (Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (ProQuest No. 10689852) Morris, E. R., & Galupo, M. P. (2019). “Attempting to dull the dysphoria”: Nonsuicidal self-injury among transgender individuals. Psychology of Sexual Orientation and Gender Diversity, 6(3), 296–307. https://doi.org/10.1037/sgd0000327 Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3). Parker, K., Horowitz, J. M., Brown, A. (2022, June 28). Americans’ complex views on gender identity and transgender issues. Pew Research Center. Retrieved from Peterson, C. M., Matthews, A., Copps-Smith, E., & Conard, L. A. (2017). Suicidality, Self-Harm, and Body Dissatisfaction in Transgender Adolescents and Emerging Adults with Gender Dysphoria. Suicide & life-threatening behavior, 47(4), 475–482. https://doi.org/10.1111/sltb.12289 Poudrier, G., Nolan, I. T., Cook, T. E., Saia, W., Motosko, C. C., Stranix, J. T., Thomson, J. E., Gothard, M. D., & Hazen, A. (2019). Assessing Quality of Life and Patient-Reported Satisfaction with Masculinizing Top Surgery: A Mixed-Methods Descriptive Survey Study. Plastic and reconstructive surgery, 143(1), 272–279. https://doi.org/10.1097/PRS.0000000000005113 Pullen Sansfaçon, A., Medico, D., Suerich-Gulick, F., & Temple Newhook, J. (2020). “I knew that I wasn’t cis, I knew that, but I didn’t know exactly”: Gender identity development, expression and affirmation in youth who access gender affirming medical care. International Journal of Transgender Health, 21(3), 307-320. Rogers, C. R. (1961). On becoming a person. Boston, MA: Houghton Mifflin. Russell, S. T., Pollitt, A. M., Li, G., & Grossman, A. H. (2018). Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 63(4), 503–505. https://doi.org/10.1016/j.jadohealth.2018.02.003 Swan, J., Phillips, T. M., Sanders, T., Mullens, A. B., Debattista, J., & Brömdal, A. (2023). Mental health and quality of life outcomes of gender-affirming surgery: A systematic literature review. Journal of Gay & Lesbian Mental Health, 27(1), 2-45. I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! 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When it comes to working with autistic individuals so we can support them, decrease their psychological distress and improve their lives, their perceptions are critical. Since we can have all the knowledge in the world but if our clients don’t think that the space supports them or if our therapy space distresses them, then this will hurt the therapeutic alliance. In turn, this will increase the chance of the therapy not being successful, so this is why creating a neurodiversity-affirming space is so important. Therefore, in this clinical psychology podcast episode, you’re going to learn why is this important, how to create a neurodiversity-affirming therapy space and essentially not simple changes can really benefit our clients. If you enjoy learning about autism, mental health and psychotherapy then this is a great episode for you. Today’s clinical psychology episode has been sponsored by Working With Children and Young People: A Guide To Clinical Psychology, Mental Health and Psychotherapy. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Why Is Creating A Neurodiversity-Affirming Therapy Space Important? I’ve already briefly mentioned in the introduction that when we want to support the needs of our autistic clients, we need them to have positive perceptions of us and our therapy space. This helps our clients, who often struggle with social connection, to trust and like us more so this topic is critical so we can have a good therapeutic alliance with them and the therapy is more likely to be successful. In addition, Mauzek et al. (2023) did research on autistic clients and the researchers found that a lot of autistic clients struggled talking in therapy and integrating the strategies they discussed with their therapist into their lives. This was typically down to their neurodivergent-specific needs. Furthermore, Norby et al. (2021) looked at the effectiveness of a group intervention for adults with ADHD and the researchers found that a lot of clients felt burdened given the demands of the group. Yet they found the sharing of personal experiences to be helpful. Overall, it’s important to note here that neurodivergent clients do find therapy useful, helpful and it works, but group settings are difficult because of the stimulation, social skills and the other challenges that being neurodivergent brings. As well as individual psychotherapy can be challenging too for similar reasons. This is why a therapist being accepting, understanding and willing to accommodate the needs of an autistic client is so important to the outcome of the therapy. Now we’ll look at five ways how a therapist can create a Neurodiversity-Affirming therapy space. Create A Sensory-Friendly Space There are certain things you just shouldn’t do when you have neurodivergent clients, but you might do this for other clients without a second thought. There is no generally correct answer, but there are better situations for different clients. For example, it is best not to have clutter, bright lights, music, a white noise machine and other overstimulating things in your waiting room or your own therapy space. This reminds me of why my best friend doesn’t like my bedroom at my parents’ house too much because I have really bright lights because they don’t bother me as an autistic person, but I know the lights are too overstimulating for them. Which is fine as we’re close friends but this wouldn’t be ideal if this was a therapy space, because it would be too much for my friend, they would hate it and it wouldn’t help us form a therapeutic alliance at all. As a result, you can create a more Neurodiversity-Affirming therapy space by having a variety of fidget tools nearby, having a range of seating options at different distances to the therapist and this includes something on the ground like a bean bag, as well as muted lights. All these options can help a therapist to create a more welcoming space where the client can feel supported and not distressed about how overstimulating the space is. Never Assume Something Related To A Client’s Neurodivergence Is A Problem If you’re a long-time listener to the podcast or a reader of my books then you know I flat out hate the term “problem” because it is blaming, judgemental and it is so medical model anyway. Therefore, when working with autistic clients, therapists should realise that being Neurodiversity-Affirming means you need to take a perspective that autism is not a problem and autism does not need to be treated. I think there are a lot of lessons for all mental health conditions there, because autistic people might benefit from assistance in working through the challenges that pop up because of a mismatch between their environment and the emotional and social challenges it causes. In addition, a lot of neurodivergent people find that their behaviours that help them cope have been historically pathologized. For example, “stimming”, these are repeated motions and sounds they do for self-soothing like rocking, humming and hair twirling, or pacing as my friend did the other night. These stimming behaviours are critical for neurodivergent people because it helps them to have a sense of comfort, so these behaviours aren’t a problem whatsoever. So please, do not think these behaviours need to be treated. Moreover, Anderson (2023) found that clients that went through Applied Behavioural Analysis, a therapy that seeks to decrease neurodivergent behaviour, universally felt negative about the intervention. Overall, when in a therapy setting, don’t try to fix or cure autism because you shouldn’t, it’s wrong and that isn’t a helpful idea in the slightest. Instead focus on the difficulties and situations that are harming the client and that will help to improve the life of your client. You Need To Listen To Understand A lot of psychotherapy modules involve some kind of fixed, very rigid structure and Cognitive Behavioural Therapy is a good example of this problem. Yet the majority of modules stress the need for the importance of making the therapy contextual and adaptable for the client. This is even more important for neurodivergent clients because each of them come with their own unique stories, perspectives and presentations, which is why I think these clinical populations are so interesting. Granted I come under this clinical population too, but still. Anyway, the key for therapists in creating a Neurodiversity-Affirming therapy space is to listen to the accounts of their clients with a drive to understand rather than jumping towards challenging what might be mislabelled as unhelpful thoughts or cognitive distortions. Since it is critical for therapists to suspend their judgement and they should validate the client’s outlook on their life. One example of this in research is Babb et al. (2021) who found that a lot of the autistic clients’ neurodiversity-specific needs like having a different experience to hunger cues or sensory sensitives compared to neurotypical people often got ignored by therapists. This is flat out wrong and this should never have happened because as a therapist, we’re meant to listen, acknowledge and try to understand how our client sees the world so we can help them. We should always try to understand how our autistic clients see and experience the world so we support them and have a more effective course of therapy. Personally, I didn’t expect to have anything personal to say about this podcast episode because my therapy wasn’t really related to my autism, except all the friendship trauma and the nightmare that is trying to navigate social relationships. But my therapist was very good at acknowledging, listening and affirming my autistic identity because we did need to talk about it and we did need to focus on the friendship aspect and social challenges of autism because it does cause me a lot of psychological distress. Yet my therapist was so good at affirming this and not ignoring my autism that I didn’t even notice she was doing this, because it was so natural to her. And I seriously appreciated this. Overall, you can create a more Neurodiversity-Affirming therapy space by simply listening, respecting and trying to understand your clients so they feel listened to. Never ignore what your clients say or are going through. Provide Your Client With Multiple Ways Of Communicating As a result of autism being a massive spectrum, talking will be great for some clients, like myself and my best friend, but it will not be for a lot of clients. Due to not everyone can process and communicate effectively with words, some clients will need pens, musical instruments and even digital communication tools to have meaningful conversations. This doesn’t mean the client is bad, wrong and messed up in any fashion but if you want to create a Neurodiversity-Affirming therapy space then you need to give your client alternatives to speech. In addition, in education settings, visual supports can be very effective in helping autistic people to learn new information (Hu et al., 2021) as well as communicating whilst moving about is easier for people with ADHD too. On the whole, when it comes to creating a Neurodiversity-Affirming therapy space, it’s important that you give your client other ways to communicate or you outright say at the beginning that it’s okay if they need to stim, move about or do anything so they can communicate effective and self-soothe too. Be Kind To Yourself and Ask For Feedback None of us are perfect people and there is no such thing as a perfect therapist, or even a perfect therapy session. As a client, there are brilliant, extremely helpful and really good therapy sessions but I think if a therapist analysed a therapy session there would always be minor things to improve. Therefore, Bachelor (2013) showed that the therapists’ reviews of therapy sessions as well as the therapeutic alliance can vary a lot. And if we think about it, this gap is likely to be even larger when the therapist and client have different neurotypes. This is why therapists should ask for feedback about how the client feels the session went, the relevance of the tools discussed and then following up on the integration of these tools at the beginning of the next session. Doing these things helps to bridge this gap. However, most importantly, you need to remember that you aren’t perfect and as long as you do the best job you possibly can then that is enough. You need to be kind to yourself because all therapy work is challenging but it is wonderful and rewarding too. It takes time to learn how to communicate, learn and help neurodivergent clients because every client’s needs are unique, so please be kind to yourself as you grow and learn. Clinical Psychology Conclusion At the end of this podcast episode, we’ve looked at how to create a sensory-friendly space, never assume something related to a client’s neurodivergence is a problem, how listening to understand, provide your clients with multiple ways of communicating and how being kind to yourself and asking for feedback all helps to create a Neurodiversity-Affirming therapy space. If you want to work with neurodivergent clients then this is more important than any of us will probably ever know. It’s important that we support our clients, improve their lives and decrease their psychological distress. That is just the standard baseline of what clinical psychologists and therapists do. However, for neurodivergence clients, the social and emotional challenges of therapy might be even more intense and distressing than for our neurotypical clients. So it is imperative that we work to create a safe, calm and affirming space where our neurodivergent clients feel safe, listened to and they can bond with us. The therapeutic alliance might be the most important factor in therapy, and it is our duty to make sure that the alliance can be established as quickly and securely as possible. This is why learning how to create Neurodiversity-Affirming spaces are so important. It’s probably the difference between us helping or failing a client. I really hope you enjoyed today’s clinical psychology podcast episode. If you want to learn more, please check out: FREE 8 PSYCHOLOGY BOOK BOXSET Working With Children and Young People: A Guide To Clinical Psychology, Mental Health and Psychotherapy. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon for exclusive access and rewards Have a great day. Clinical Psychology References and Further Reading Anderson, L. K. (2023). Autistic experiences of applied behavior analysis. Autism, 27(3), 737-750. Babb, C., Brede, J., Jones, C. R., Elliott, M., Zanker, C., Tchanturia, K., & Fox, J. R. (2021). ‘It’s not that they don’t want to access the support... it’s the impact of the autism’: The experience of eating disorder services from the perspective of autistic women, parents and healthcare professionals. Autism, 25(5), 1409-1421. Bachelor, A. (2013). Clients' and therapists' views of the therapeutic alliance: Similarities, differences and relationship to therapy outcome. Clinical psychology & psychotherapy, 20(2), 118-135. Beauvais, V. Identity-Affirming Approaches for Autistic Clients: Therapists Best Practice. Bonanza, C. E., Index, H., McNulty, K., Center, L. K., Stark, M., & Lite, D. B. T. Neurodiversity Affirming Understanding and Care for ADHD. Gaddy, C., & Crow, H. (2023). A Primer on Neurodiversity-Affirming Speech and Language Services for Autistic Individuals. Perspectives of the ASHA Special Interest Groups, 8(6), 1220-1237. Hu, X., Wang, H., Han, Z. R., Zhao, Y., & Ke, L. (2021). The influence of visual supports and motivation on motor performance of the MABC-2 for Chinese school-aged children with autism spectrum disorder. Scientific reports, 11(1), 15557. Johnston, L., Maciver, D., Rutherford, M., Gray, A., Curnow, E., & Utley, I. (2024, March). A brief neuro-affirming resource to support school absences for autistic learners: development and program description. In Frontiers in Education (Vol. 9, p. 1358354). Frontiers Media SA. Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, research, practice, training, 38(4), 357. Mazurek, M. O., Pappagianopoulos, J., Brunt, S., Sadikova, E., Nevill, R., Menezes, M., & Harkins, C. (2023). A mixed methods study of autistic adults' mental health therapy experiences. Clinical Psychology & Psychotherapy, 30(4), 767-779. McGreevy, E., Quinn, A., Law, R., Botha, M., Evans, M., Rose, K., ... & Pavlopoulou, G. (2024). An experience sensitive approach to care with and for autistic children and young people in clinical services. Journal of Humanistic Psychology, 00221678241232442. Nordby, E. S., Gilje, S., Jensen, D. A., Sørensen, L., & Stige, S. H. (2021). Goal management training for adults with ADHD–clients’ experiences with a group-based intervention. BMC psychiatry, 21, 1-12. Simpson, B. (2020). An open letter to the psychotherapy and counselling profession: It is time to recognise the politics of training and practising with Tourette's syndrome. Psychotherapy and Politics International, 18(3), e1549. I truly hope that you’ve enjoyed this blog post and if you feel like supporting the blog on an ongoing basis and get lots of rewards, then please head to my Patreon page. However, if want to show one-time support and appreciation, the place to do that is PayPal. If you do that, please include your email address in the notes section, so I can say thank you. Which I am going to say right now. Thank you! Click  https://www.buymeacoffee.com/connorwhiteley for a one-time bit of support.