Psychologist San Francisco

This is a guest post by Ryan Witherspoon, MA. Ryan is a psychology graduate student, completing his MA at Pepperdine University and preparing to enter a doctoral program this Fall.  He is training to become a clinical psychologist and will eventually work in private practice, teach and conduct research. He intends to specialize in working with sexual minority (LGBTQA, kink, poly) clients as well as their relationships and families.

Last month I was fortunate to present a poster titled “Polyamory as a Cultural Identity: Implications for Clinical Practice” at the National Multicultural Conference and Summit in Houston Texas.  The poster presented a literature review on polyamory geared towards clinicians, woven together with my ethnographic impressions, sample case vignettes and comments from clinicians both with and without experience serving this population.

The notion of positive and successful consensual non-monogamy continues to be a controversial topic in the psychological community.  This is especially true for polyamory, which so far seems to retain the fringe attribution that other forms of consensual non-monogamy, such as open relationships or swinging, have gradually sloughed off via growing public awareness (and tacit acceptance) of these practices.  However as I discussed in my poster, it is becoming increasingly evident that polyamory may be far more common than many realize.

Given my premise that polyamory can constitute a distinct and evolving culture, it seemed fitting to present at a conference dedicated to multiculturalism.  However I must admit to feeling anxious about how my poster would be received.  Waking nightmares of distinguished psychologists angrily and loudly contesting, or worse – cursorily dismissing my work haunted me in the days leading up to the presentation.

Fortunately, as with my symposium presentation on LGBT polyamory at last year’s APA convention, the response could not have been more positive and encouraging.  Every single person I spoke with was incredibly enthusiastic about the topic and my work.

My poster received an enormous amount of interest and traffic; I spent the entire 90 minute session talking to people individually or in groups.  It seemed like nearly everyone who saw the title stopped to stay a while.  The important take-away for me however was not just the positivity of psychologists’ reactions, but the particular flavor of them.

Beyond appreciating the poster, numerous people personally thanked me for sharing work on this topic.  Their reactions were as much emotional as intellectual, expressing relief and gratitude.  Psychologists and students alike spoke with me about the dire need for greater awareness of these issues among the clinical community.  Numerous times throughout the session clinicians told me stories of polyamorous clients at their practice, clinic or school that nobody knew how to work with.  I heard reports of biased supervisors, ignorant trainees, and clientele whose needs were going unmet due to the paucity of clinically-relevant knowledge on alternative sexualities.

My experiences presenting on polyamory at APA and the National Multicultural Conference and Summit have reinforced my belief that alternative sexualities are rapidly growing in participation and visibility.  I sincerely hope that expanding education and training among clinicians about these populations will ameliorate widespread biases and gaps in knowledge.

Diversity and multiculturalism are by definition expansive and inclusive concepts.  Therefore I believe that – as with LGBT populations decades ago – we must embrace the fact that these communities exist, they are more common than many realize, and psychologists must rise to the occasion by establishing standards of culturally competent care for them.

View the poster.

The most common consultation question I’m asked is “What can I do about the negative Yelp review I just received?”

Until now, there hasn’t been much that we can do other than do good work, listen to our clients’ feedback, and hope that we don’t upset someone enough for them to want to publicly complain about our work on the Internet. My typical first response to someone who just got a bad online review is to recommend that they take a deep breath, try to shake it off, and seek support from their colleagues and people who know them and their work.

But for two years, I have been working on a solution. In my trainings, I’ve recommended that the best way for clinicians to manage this is to take steps to put client feedback back into their own hands by developing post-treatment feedback forms and getting client consent to post aggregate data on their sites.

Sample Referral Graph

Nine months ago, I developed a questionnaire asking psychotherapy clients what they would most like to find in online reviews of therapists. One hundred and thirty-six participants responded and I used that data to develop a follow-up survey. I’ve been using my own follow-up form in my practice for almost two months, as well as implementing an ongoing feedback form. I’ve also had a couple of other clinicians alpha test this in their own practice.

To view a preview of the data I’m getting, peek at my Client Feedback page.

Now you can get your hands on this survey because I’m releasing it in a public alpha launch.

Here’s how it works.

You pay a very reasonable set-up fee, I will host your form, then you send the link to your feedback survey to clients who have completed treatment with you and wait for your results to come in. Once you have 15 completed surveys, you will be sent an aggregate view of your data. If you’re itching to know how many responses you’ve gotten before you reach your 15, go ahead and check in with me and I’m happy to let you know.

Sample therapy goals graph

Why the wait? We wait for 15 clients to complete the surveys to help protect the privacy of your clients. The goal is to see how you are doing generally, not person-by-person. And the potential end-user of this site is clients who are looking at your ratings online. If you like what you see and want to continue using the form, you can pay for a monthly (or yearly subscription, at a lower rate).

Also, some research indicates that it takes 6-10 local reviews for a business to gain trust from consumers. We want to make your results a bit more robust for you and your potential clients.

Every time you get 5 more responses, you’ll get an updated graph with a time and date stamp.

If you want to get a better idea of how your current clients feel about how their therapy is going, signing up also gets you a PDF of a Checking In form you can give to your current clients to see how they feel about how therapy is progressing.

How is this ethical? For one thing, it is sent only to clients you have completed therapy with, and with their consent. No testimonials or text-based responses are shared with anyone but you. Aggregate data is revealed which does not compromise the identity of participants to you, or to the public (or to their friend lists or Facebook. Bleh!).

How is this good for me? If you wait out the initial period as you build your feedback data, and send this to all clients you complete treatment with, you will have an alternative data point that you can post online to show people “Hey, I sent this to all of my clients, and here is what they are saying about my services.” This can take the sting out of the unfortunate experience of getting a negative online review from one disgruntled client.

You’ll also get a very good idea where your growth edge is and how you may be already excelling in your care and where you may need to pay a bit more attention. And if you choose to keep your feedback private, you can simply use it as a tool to improve your services.

How is this good for clients? It helps them to find out the information they want to know about you and your practice: the issues you treat, what you’re especially good at, and whether people who work with you would be comfortable referring others to you. It also protects their privacy without exposing their personal issues to their friend networks or the public. And it gives them a chance to honestly give you feedback, without any negative consequence. I believe that in our changing culture of Internet transparency, it also lets clients know that you are willing to stand behind your services and receive feedback about how you’re doing.

Do you want to take control of client feedback and make sure you know how your clients feel about your services? If the answer is yes, join me in my alpha launch.

Get started now by adding “Yelp-Proof Your Practice” to your cart in my online store.

I’ll follow up with an email with the FAQ, and giving you all you need to get started. If you have questions and concerns, we’ll chat on the phone and I can tell you more about my experiences with this product.

As an alpha launch partner, I’ll also be asking you for some feedback of your own, sharing what you like and don’t like about the product, and you can have a hand in fine-tuning it and shaping it.

I hope you’ll join me in this new venture and adventure!

If you’re looking for other resources about managing Yelp, I highly recommend the articles below:

Ofer Zur’s brand new post on Modern Day Digital Revenge offers many tips and resources for dealing with online reviews.

Matt Lundquist of TriBeCa Therapy in New York had a creative and human approach to dealing with his own negative review on Yelp.

Pysychotherapy Finances did a review of what you can do about Yelp, interviewing me and Dr. David Ballard, last year.

A recent blog post of mine had a number of experts weighing in on what you can and can’t do and whether those posting reviews of our services still have a right to confidentiality.

My New York Times Op-Ed, The Wrong Type of Talk Therapy, was when I first began wishing for an alternative to online review sites which might better protect consumers.

Lastly, some people have taken to adopting my language from my own Yelp page and using it on theirs. I allow any and all clinicians to use this on your page, if you wish.

Originally published at Psyched in San Francisco

The popularity of the 50 Shades of Grey books has been staggering. They have become the 9 1/2 Weeks of a new generation; glorifying the excitement of power, bondage, and…well, mind games. In fact, those who know what consensual BDSM participants actually do together have criticized the trilogy for portraying kinky sex as unhealthy and non-consensual. Others note that some of the activities in the book convey a lack of knowledge about keeping BDSM physically and psychologically safe.

However, it is clear that the public is fascinated by kinky sex. In fact, 14% of American males and 11% of American females have engaged in some form of BDSM sexual behavior (Janus & Janus, 1993). But BDSM remains a taboo topic in the field of mental health where sexual diversity training focuses primarily on the experiences of gay, lesbian, and bisexual individuals. Despite removing homosexuality in 1986, the Diagnostic and Statistical Manual of Mental Disorders continues to list Sexual Sadism and Sexual Masochism as Paraphilias, or sexual disorders.

The tension between public interest in BDSM and outdated training of clinicians has created opportunities for psychotherapists who identify as “kink-aware” or “altsex friendly,” to identify themselves to savvy psychotherapy clients. These clients want to avoid wasting their time and money spending hours in therapy only to have their proclivities pathologized by clinicians who know nothing about their lifestyles. In fact, Kink-Aware Directories and Poly-friendly Directories exist to help consumers find a wide range of services from informed professionals. The Bay Area even has its own group: Bay Area Open Minds, to help clinicians network and to help clients find us.

Just as it’s not easy for all people to “come out” to their friends, family, or co-workers as kinky or polyamorous, it’s also not always easy to come out as an altsex-friendly mental health professional. Those of us who advertise these services – whether we identify as altsex clinicians or just allies — face the same challenges BDSM and poly clients face. Many health professionals believe that alternative sexuality is a sign of illness. If you truly want to see power dynamics in action, try coming out as an altsex friendly trainee in a psychology graduate program. It takes strength, courage, and support to do so surrounded by ill-informed colleagues. It is even more challenging to do this if you are a student, very much in need of affirmation from professors and supervisors.

Sexuality remains such a forbidden frontier that if one speaks up
 about the experiences of sexually marginalized people, it is assumed that they must be a member of the group. This circumstance keeps some altsex clinicians and their altsex positive allies silent. By contrast, few clinicians would worry that by specializing in treating substance abuse, eating disorders, anxiety, or depression, people might think they are in recovery, bulimic, depressed, or anxious. But most cannot imagine why a person would willingly speak up about kink in our field unless one were kinky herself.

I am a kink and poly-friendly professional who works with altsex clients. I discuss my altsex research, teaching, writing, advocacy, and clinical work in many professional settings. There are many reasons to be an altsex positive clinician. You may
 have known and loved someone who is kinky or poly, as a friend, partner, or family member. Maybe you have had your eyes opened to your own biases and judgment and want to make a difference. Maybe you believe in everyone’s right to fantasize or engage in consensual sexual acts, regardless of whether you experience the same desires. I believe that all clients deserve a safe, non-judgmental place to talk about their fantasies, behaviors and identities.

It is my hope that the public’s interest in exploring these fantasies and ideas in stories and media may begin to expand our notions of what is normal and will help change outdated ideas about sexual pathology. If every other person on BART and MUNI is reading 50 Shades of Gray, a book about sex and power, then shouldn’t it also be safe to go to your psychotherapist’s office and explore these issues there?

Janus, S., and Janus, C. (1993). The Janus Report on Sexual Behavior. New York: John Wiley & Sons.

The following is a guest post by Douglas C. Haldeman, Ph.D. who has been a Counseling Psychologist in Independent Practice in Seattle for 29 years. His long publication record includes over forty articles and book chapters on issues of Diversity, Ethics, Family systems, Practice Guidelines for marginalized groups, and competent treatment of lesbian, gay, bisexual and transgender individuals and families. He has lectured on the relationship between culture, family and mental health all over the world. Dr. Haldeman is also currently running for APA President. You can find out more about his campaign here. This blog post was originally published at Boomer Premier Dating.

Gay, Older, and Dating: I Have Survived! Now What?

I am lucky to be a veteran of 40+ years of living as an out gay man and a psychologist in the LGBT community.  Living in the San Francisco area in the Seventies, I enjoyed the Disco Revolution; I marched with Harvey Milk; I sat bedside during the Eighties and Nineties at the deaths of countless patients and friends; and I did my part to rebuild our community in the ‘00s, and have thankfully lived to tell the tale.  If you are reading this, you may be an older gay, lesbian, trans or bisexual person – which in our community could be anyone over 40 – and looking for love. Or you may be on your way to becoming an older gay person, so read on.

Let me first say that if you are looking for a one-nighter, fair enough: many older queer folk are not interested in a long-term relationship (LTR), or even dating, for a number of reasons.  Perhaps you have left or lost a partner, and are not up for the complexities of an LTR.  Or maybe you are simply too accustomed to the independence of single life.  Whatever the reason, by this stage in life, you know where to find what you need: online hookup sites (Scruff, Grindr, Manhunt, Adam4Adam, Craiglist) or the more traditional in-person, impersonal venues.

But if you are interested in dating, and the possibility of finding an LTR – either again, or for the first time – read on.  This article is dedicated to Boomers/Seniors looking for relationships, and many of the recommendations that apply to heterosexuals work for us too (see below).  But for LGBT Boomers/Seniors, there are some unique considerations in the mature quest for love.  As a psychologist who has worked with LGBT people from all generational cohorts for thirty years, I have some ideas that may help you in your search:

• Know what you want, and focus accordingly: These days, because of the Internet, it is much easier to connect with like-minded people in terms of dating.  Consider where you are in your life, and what you want: is it an LTR?  Casual dating?  Friendship?  What kind of people are you attracted to?  Those in your own generation, or others?  Be honest with yourself and others.  Engage with those whose relational goals are similar.

• Stay open: Be flexible in your “requirements”.  Also, be flexible in your choice of venues.  For instance, do you remember what it was like before computers “back in the day” when we actually met in person?  Go to bars; if you don’t like them, or don’t enjoy alcohol-saturated environments, join community groups; volunteer for LGBT causes.  If you live in a rural area where these options are not available, use your computer to connect – or take a deep breath and try and start a club/interest group where you live.

• Focus on what is under your control, and leave the rest: Are there demons in your head, telling you that you’re too old/too fat/too washed-up to find a loving relationship?  Don’t do that to yourself; these thoughts must be confronted and replaced with positive thoughts, because they will not help you feel confident in your presentation to others.  Are you comfortable in your own body?  If not, take steps to address that.  It helps.  Regardless of your age or ability status, everyone can find something active that they like to do.  Be content with who you are and what you have, and it will be much easier feel good about yourself when you meet others – of any age.

• Be honest: You know by now that ours is a youth-obsessed community, and it is easy for older people to feel invisible or marginalized.  Don’t buy into that; if you are patient, and sure of yourself, you will meet your Prince or Princess.  But you can’t lie, especially on the Internet, where lying seems to be the lingua franca of communicating.  Tell the truth about yourself (age, weight, SES, whatever) – you know that whomever you are interested in is going to find out the truth sooner or later.  Be up-front and you’ll feel better about your communications.

• Don’t despair: there is a market for everyone: So you think you are over the hill, and that no beautiful person will ever look at you again?  Think again.  It’s easy to worry about that (see above), but don’t allow yourself to go there.  It will not help you achieve anything, and will erode your self-esteem.  Be vigilant against toxic thinking!  Attend community groups where the participation of older LGBT people is valued; if you go out, visit bars/clubs/coffehouses that have mixed-age clientelte.  And online?  There are good resources available for meeting people form all over the world who admire us older folk: Silverdaddies and Caffmoscommunity are a couple of reputable sites.

• MOST OF ALL, EMBRACE YOUR AGE:You are likely used to feeling that being over 40 is a deficit in our community.  If you are indeed over 40, challenge that thought: you cannot change your age, but you can change your attitude about it.  You are mature; you have wisdom; life experience; and a lot to offer.  Make your self-talk more positive with activities that bolster your confidence.  Get to the gym.  Hang out with your friends.  Make time for the things that enhance your self-care, whatever they may be, and for God’s sake, stop working so hard.  And if you don’t want to be in a relationship after all?  Absolutely fine.  We are gay, after all; we have already broken the boundaries of heterocentric social expectations (in plain English: social norms of living like straight people), so if you are more comfortable as a single person, good for you.  Let it be.

• Follow the basic recommendations for straight Boomers/Seniors: Some of these apply to us, and let’s start with safe sex.  In the past few years, the CDC has reported an alarming increase in new HIV infections in gay men over 50 – an age cohort that has survived the initial wave of the health crisis.  What’s going on?  My theory is that so many of us older guys feel invisible, or just generally bad about ourselves, that we are willing to accept any kind of sexual attention, even if it is unsafe – especially if we have had too much to drink.  Don’t do it.  You know the rules of safe sex by now.  Follow the rules for online dating that straight people endorse: get to know someone, be slow to trust them, meet informally and publicly at the beginning, etc.

• Use the resources dedicated to online dating for gay Boomers/Seniors: There are a number of reputable websites that offer advice, resources, social alternatives, and online communities for connecting with other LGBT Boomers/Seniors as those people who are interested in getting to know us better.  They include the AARP’s page for gay online dating, OutMaturity, and FromGaytoDecember.  Check them out.

Last but not least, enjoy yourself!  This can be an amazing time of life.  After all, we have survived (paraphrasing Gloria Gaynor), and as time goes by, we understand how precious life is.  Embrace your age and accept whatever health challenges you may have.  Put yourself out there.  Chances are, someone is waiting.

I had a very busy time at the annual American Psychological Association Convention this year in Orlando. I did four very different presentations in the four days I attended, which was a stretch! I also got to network with some incredibly interesting and accomplished psychologists who regularly support, encourage, and inspire me. I usually only get to “connect” with these folks via email or Twitter, so it was a treat. And, to top it all off, I brought my mother with me, which was a first for us both at a professional conference.

A highlight for me was watching the APA Ethics Committee, led by Stephen Behnke, JD, Ph.D., Director of the APA Ethics Office leading a session on hot topics in ethics in which the packed room all got to participate and share ideas. Another treat was having leaders I’ve admired for a long time attend my own presentations and come up afterwards to express appreciation. Moments like that can be incredibly meaningful to me as I move into becoming a mid-career psychologist. One such example was Dr. Philip Zimbardo coming up to to me after a talk I gave, and then watching him receive his Distinguished Lifetime Contribution to Media Psychology Award the next evening. Cool stuff.

I was also delighted to see one of my very favorite professors, Dr. Rhoda Olkin, receive her award from the Committee on Disability Issues in Psychology (CDIP). Dr. Olkin gave a very well-received talk on her great work on living with disabilities and working with clients with disabilities. If you haven’t read her book What Psychotherapists Should Know About Disability, you should go get it now.

Dr. Esnil, Dr. Mendoza-Newman, and Dr. Kolmes after the Roundtable

My presentations included the following, (and I’m grateful to my colleagues for teaching me so much in these presentations):

Transmedia Storytelling: Creating Engagement and Meaning in Business, Education, and Clinical Practice, with Pamela Rutledge, Ph.D. and Jerri Lynn Hogg, Ph.D.

Stigma Squared: Understanding Kink in LGBT Communities: The Revolution Within: Sexpositivity and Celebrating Sex Within LGBT Communities, with Theodore R. Burnes, Ph.D., MEd, Ryan Witherspoon, B.A., Anneliese A. Singh, Ph.D.

Connections, Intersections and Coalitions: Feminist Healers Group, Roundtable Discussion, with Edna Esnil, Psy.D. and Mary Mendoza-Newman, Ph.D.

Symposium on Social Media in Long-term Care Settings: Roles, Responsibility, and Unlimited Possibilities, with Mary M. Lewis, Ph.D., Geoffrey W Lane, Ph.D., Eleanor Feldman Barbera, Ph.D., and Patricia L. Bach, Psy.D., R.N.

Next year, APA will be held in Honolulu, and my goal is to engage in more relaxation and maybe just do one or two presentations.