I’m back from SXSW, where I got rained on HARD and also got to network and socialize with some of my favorite people. My session was on the challenges raised by consumer reviews of healthcare providers. You can read the Storify story of tweets below.

Thanks to everyone who came and asked great questions!

Check out the audio from my segment of our presentation:

My slide:

You can also hear the full audio here, and view the Storify tweets below.

Tweets from SXSW session WARNING: Are Online Reviews Bad for Your Health?

Session moderated by Cindy Cohn, Legal Director of EFF. Panelists: Jeffrey Segal, CEO of Medical Justice, Dr. Keely Kolmes, SF Psychologist in private practice, and Vince Sollito, VP at Yelp.

Storified by Dr. Keely Kolmes · Mon, Mar 12 2012 14:21:29

I’ve created a very brief survey to gain a better idea of the types of information that would be most useful to psychotherapy clients when looking at online reviews of mental health professionals.

This survey consists of three questions and can be easily answered in just a few minutes. I do not ask for any personal information about you.

Please help me by taking a couple of minutes to complete the survey and also sharing it with your friends.

The survey can be found here.

Thanks so much for your help.

In 2009, I did a presentation at SXSW called Therapy 2.0: Mental Health for Geeks, even creating a corresponding wiki with resources. A month later, I spoke at the first Mental Health Camp for bloggers in Vancouver on the intersection of social media and mental health.

Looking back, it seems ironic that I haven’t written much since then about mental health or mental illness in tech culture especially when I consider that a large proportion of the people who seek my help have careers in tech. It’s as if I’ve forgotten that it’s worth mentioning.

And it’s really not.

Prodded by the recent suicide of Ilya Zhitomirskiy, one of the co-founders of Diaspora (a site, I had eagerly awaited due to multiple privacy failings on the part of Facebook), Violet Blue wrote a great post about called Tech’s Relationship With Depression, Suicide and Asperger’s. I share many of Violet’s concerns and she interviewed me for this article which includes a number of my comments.

Our friends and family in tech culture may suffer and struggle in ways that we may not see or just may not know how to identify. It’s hard to get someone the help they need when you don’t know they are suffering or if their coping or personality style involves masking their pain.

It’s not that people in tech are so special or different from anyone else, but working in the digital realm does involve the pressures of internet attention, visibility, or “celebrity,” which can sometimes be unexpected and overwhelming. Others may not realize that their normal ways of coping keep them isolated and deprived of support. I hope people will check out Violet Blue’s post which provides links to APA and NIMH’s resources for depression and suicide.

And if you or someone you know needs help, find a professional who you can talk to about your stress. There are low-fee options in every city. College counseling centers and counseling, psychology, or social work training sites may be good places to look for low-fee options. Larger sites such as APA’s Psychologist Locator and Psychology Today provide listings for private practice clinicians.

But whatever you do, talk to someone and let them know that you need some support. There is no need to suffer in silence. People are there to help you, and if you are thinking of taking your life, know that you will leave behind people who will miss you and who will wish they could have reached out to help.

In addition to seeing clients in my private practice, doing research, and teaching, I am also the Digital Director for APA Division 42, Psychologists in Independent Practice.

We’ve just completed a Youtube video on the benefits of talking to a psychologist, and I’m pleased to share it here. Please do pass it along if you think it may help someone.

I’m happy to report that our slides are up summarizing the data Dan Taube and I collected on clients encountering their psychotherapist’s information on the Internet.

We will soon be writing up our findings to submit for publication, but I’m pleased to be able to share this data with all of the folks who participated in our research and those who helped us reach out to potential participants. We could not have done this without the magic of social media and all of your help!

I’m very appreciative and I hope that our findings help bring greater awareness and understanding to how the Internet and social media are impacting the psychotherapy relationship.

May is Mental Health Month, and I’m joining the Mental Health Month Blog Party to help decrease stigma about mental illness.

Many people have huge barriers to seeking help when they are struggling. Sometimes these barriers are financial. Some folks may not be in a location in which it is easy to find good care from a variety of providers. Some are unable to find the strength to reach out for help. Some folks want help but they may have difficulty finding a therapist who is sensitive to their cultural needs or who has expertise working with their particular issues.

This is one way that blogging and the Internet can increase access. It is becoming easier to find help, whether that comes through seeking online support or searching for a clinician. Some people are utilizing telehealth services to reach out to practitioners outside of their communities. Others are able to find information and resources shared by others and not feel so isolated.

One of my own practice specialties is working with sexual minority clients who have traditionally been pathologized by mental health professionals. It can be intimidating to seek care for anxiety, compulsive thoughts or behaviors, depression, or relationship concerns if you worry that your therapist will assume that your identity or lifestyle is a cause for concern. If you need help finding a therapist who is knowledgeable and accepting of your kink, poly, or LGBT identity, please see my favorite resources below:

• Kink-aware professionals is a directory to help you find a referrals to psychotherapeutic, medical, legal and other professionals who are knowledgeable about and sensitive to diverse expressions of sexuality.
• Poly-friendly professionals is a list of professionals who have been referred or who have identified themselves as being, open-minded about polyamory and polyamorous issues.
• Gaylesta is a Bay Area, CA resource providing therapist referrals, education, and consultation to LGBTQ clients, but there is likely a similar resource in your community.

For more general information and articles, I recommend people look at what is available at these sites:

• American Psychological Association: browse the psychology topics to learn more
• PsychCentral has become one of the largest and most resourced hubs of mental health information, support, and community on the web.

Lastly, here are two of my favorite mental health news items of this week:

• Self-compassion may matter more than self-esteem explains how developing the skills of mindfulness, common humanity and kindness can improve your mental health.

• If you think it’s hard to take the steps to seek mental health care, it may reassure you to know that the majority of mental health professionals believe in therapy for themselves. At this link, Suzanne Phillips, Psy.D., ABPP shares  some research reporting that 84% of psychologists and 85% of cross-discipline mental health professionals have also sought mental health treatment.

Are you a person 18 years old or over, who has been in psychotherapy, and has sought or found information about your therapist on the Internet? If so, we would appreciate your taking the time to complete a survey.

Our names are Keely Kolmes and Dan Taube and we are licensed psychologists who would like to request your participation in our research on the effects of encountering your past or current therapist’s information on the Internet. This study has been approved by the Institutional Review Board of Alliant International University.

As a participant, you will be asked to complete an online survey covering your basic demographic information and your experiences regarding seeking or accidentally discovering information about your therapist on the Internet. We expect the survey to take about 20 to 35 minutes to complete.

Your input may help therapists to better understand if and how this information affects clients.

No names or personal information will be linked to the study and your participation will be completely anonymous so long as you do not put your name in your responses. If you should wish to contact the researchers directly, your participation may become confidential rather than anonymous, although your name will not be linked to any of the data you submit.

To be eligible for the study, you must be 18 or older, currently in psychotherapy, or have been in psychotherapy in the past, and have encountered or sought information about your therapist on the Internet.

If you meet the above criteria and are interested in participating in the study, you can access the survey at:

http://www.surveymonkey.com/s/finalclient

If you do not qualify for the study but you know others who might be interested in participating, feel free to forward this notice or URL. You may also share our research page with others on Facebook.

Thank you for your interest and participation.

Sincerely,

Keely Kolmes, Psy.D. moc.liamhsuhnull@semlokkrd

Daniel Taube, Ph.D., J.D. ude.tnaillanull@ebuatd

Therapist-Client Interactions on the Internet

Thank you to everyone who participated in our survey. The summary of the results of the research Dan Taube, J.D., Ph.D. and I conducted on psychotherapists who have had intentional and accidental extra-therapeutic encounters with their clients on the Internet are posted on my research page. A larger slideshow can be viewed here.

To read a brief lit review and description of the research, please see our article Clinical implications of therapist-client interactions on the Internet: Boundary considerations in cyberspace.

I am frequently asked for advice from graduate students in counseling and psychology. Here are my top three tips for graduate students studying to become MFT’s, LCSW’s, psychologists, and counselors. If you keep these things in mind, you can learn to care for yourself – not just your patients!

1. Learn balance & self-care strategies early

It’s common sense that we can’t really care for others if we are unable to care for ourselves. But this lesson can be a difficult one to learn as a beginning therapist. It is a huge adjustment to learn how to manage a full caseload of different people with different personal stories and challenges. When you’re just starting out and also working extra hard to master different techniques and approaches to different problems, you may be especially vulnerable to taking your work home and thinking (perhaps even obsessing!) about your cases and how you might better help your clients.

Interns are especially vulnerable, and they can sometimes feel abused by the training process: you will be working long hours, frequently without any financial gain, and sometimes with challenging cases or groups of people. This is a great time to learn what you need to re-balance yourself. Perhaps it’s yoga and meditation or exercise. Maybe it’s time with friends and family. Maybe it’s a warm bath by candlelight at the end of the night, or cooking dinner, or engaging in a marathon of your favorite TV shows on DVD. But self-care can also include rituals that help you re-charge between sessions too, such as a five minute breathing exercise or stretching.

If you feel overwhelmed by your cases or you believe that your caseload is unbalanced (too many clients dealing with trauma, for example) talk to your supervisor and try to get help reducing your number of intakes or see if you can create more balance in the different types of new cases you take on.

2. Avoid isolation & try co-working

One of the other painful lessons of graduate school can be learning to say no. If you are also juggling a dissertation, family life, or a part-time job, you may find you have to say no more than you’d anticipated to a lot to social activities and fun. After just a few weeks of this, you may feel extremely socially deprived.

Don’t forget that socializing can be a huge stress reliever and that there may be ways to integrate social contact into productivity. Co-working is one way to do this. Try studying with a pal or with a small group. Make work dates in coffee shops or set up a work date that includes a dinner break. You may feel less isolated and socially impoverished if you are able to connect with a friend and get some work done.

You may also find that you have other friends who are not in school but who have projects they need to work on. Learning that you can connect with someone else and keep company while being productive or working on different tasks is a nice compromise and can avoid black or white thinking around whether you can make plans.

3. Start a consultation group

“Why would I need a consultation group?” students ask me. “I already have group supervision and other classmates.” Sure, you have several built in support groups, but sometimes it’s nice to develop a smaller team of people to meet with who are not affiliated with a class or an agency. If you have tension with another intern or if you ever wrestle with how to communicate about something challenging with a supervisor, a consultation group is a great way to learn to formalize professional consultation and get ongoing support and feedback from your peers.

I started my own consultation group in my second year of graduate school and we have met every 1-2 weeks for the last thirteen years. I think it’s safe to say that no other clinicians know my clinical thinking better than those in this group. As we developed from graduate students to licensed clinicians, our group provided feedback and support for professional milestones including the dissertation, licensing exams, and job-seeking (we have served as professional references for one another).

My recommendations for starting your own consultation group are to try to find a balance between safety and growth. Of course, you need to find people with whom you feel comfortable sharing your biggest struggles, challenges, and vulnerabilities. This may make it tempting to select others who have similar approaches. But it can provide great richness to consult with people who represent other theoretical and sociocultural perspectives.

Learning how to respectfully engage with other colleagues who have different approaches or areas of expertise is an invaluable experience. Of all of the professional commitments I’ve taken on, I feel that starting my own group as a graduate student was one of the wisest investments I ever made in my future as a psychologist.

Summary

Graduate school is hard. You’re putting part of your life on-hold to learn something new and invest time, money, and a good piece of your heart in developing new skills. Learning to provide psychological care to others has its own unique stresses and challenges. I hope that my tips can help graduate students to support their own mental and emotional health and move on to becoming successful post-graduates.

Our networking group for Bay Area Psychotherapists has a new mission statement:

We are a group of San Francisco Bay Area psychotherapists and psychotherapy students who affirm that sexual and gender diversity are natural expressions of the human experience.

We provide a safe haven for mental health clinicians to gather, network, support, and
consult.

Our psychotherapy practices welcome and serve:

● Clients who engage in consensual sexual behaviors, including but not limited to kink and polyamory.
● Clients who are gender variant.

Our group welcomes:

● Students seeking mentorship in working affirmatively and responsibly with said clients.
● Professionals seeking networking, support, and consultation in working affirmatively and responsibly with said clients.

We are committed to expanding affirmative psychological understandings of sexual and gender diversity, and to counteracting the historical and present day harm done by pathologizing diagnoses, stigma, and invisibility.

We are committed to identifying standards of affirmative and culturally competent care, and to sharing this information with each other and our colleagues so that we may better serve our clients and their communities.

We have all agreed to abide by the ethical guidelines of our respective disciplines.

If you are interested in joining our group, please email Keely Kolmes, Psy.D. PSY21284

In your email, please provide your name, license, practice and/or school information, and a brief bio about your interest in the group. This information will be shared only with other members of our group.

We look forward to hearing from you!