A Call for More Services for Families with Loved Ones with Serious Mental Illness

With all the talk about healthcare reform and budget cuts to healthcare programs, my colleague, Jerome Yoman, PhD, and I were inspired to write an editorial about the need for more family services for The Oregonian, our local newspaper. We just found out that the editorial was published in the April 10, 2012 edition!

You can read the editorial by clicking on the linked title below:

Plans for Treating Mental Illness Should Encourage Family Involvement

-By Christeine Terry, Ph.D.

Research graveyard may come to life

“If enough data is collected, anything may be proven by statistical methods”

Williams and Holland’s Law

It’s an amazing day for scientific research! Hold on, don’t leave me yet. I know I typically try to post things here that are inspiring or at the very least interesting and directly applicable to your everyday life. And the behind-the-scenes politics and procedures of conducting scientific research generally wouldn’t be thought to fall into the “inspiring” category. But trust me, this matters to you!

The All Trials Campaign has organized experts from around the world who are demanding that all unpublished data from clinical medication trials be published and all misreported data be formally corrected. Just this month, the British Medical Journal (BMJ) and PLOS Medicine have taken up the call of the “Restoring Invisible and Abandoned Trials” initiative (RIAT), endorsing the proposal that sponsors and researchers begin publishing the results of their previously confidential clinical trial documents within one year. If they fail to take these actions, RIAT would call for independent scientists to publish those previously confidential trial documents.

To understand why this is such a potentially momentous move, it’s helpful to first understand a bit about how the world of scientific publishing works. At the heart of the problem is the fact that, in general, only studies that find “significant” results get published, and here the word “significant” means that the study found that the particular drug/intervention/treatment being tested was effective. On the surface this practice seems to make sense. I mean, would you sit down to read a newspaper that had a bunch of titles like “Nothing at all happened in Portland last night” and “Nobody did anything of significance in Congress yesterday” (ok, well, maybe that one doesn’t seem like a stretch!). Those of us who read journal articles to get our news about the latest developments in our field want to spend what little time we have reading articles about treatments that actually seem to work. We’re generally less interested in studies that fail to find that a particular treatment works. The result is that studies showing that a treatment doesn’t work, or worse, caused harm, are often unpublished.

However, the problem with state of affairs is that it gives health care providers and the public very skewed information. For every study we hear about that shows a particular drug or treatment supposedly works, we never know about the potentially countless other studies that showed that it didn’t work, or even that it caused harm. And the picture gets even more worrisome when you take into account how most research is funded in the first place.

The vast majority of scientific researchers are only able to do their work through grant funding (though we have a different model here at Portland Psychotherapy for funding our research which you can read more about here). One way this happens is that a researcher, who is very interested in a particular treatment, spends months writing and rewriting a grant application to ask some institution, such as the National Institutes of Health (NIH), essentially asking them for money to study their idea. But even more frequently, it isn’t the NIH or some other arguably unbiased institution that is funding research. As funding from places like the NIH have dropped drastically in recent years, “industry funded research” (e.g. research paid for by a company that is highly invested in its outcome) has soared, with industry-funded research in universities increasing 250% from 1985 to 2005. Increasingly, researchers are paid by a particular company, often a big pharmaceutical company, who has a vested interest in showing that their product (e.g., their drug) is effective.

Now let’s return to the problem of only publishing “significant” findings. If only those studies that show a “significant” result (e.g. that the drug “Y” was more effective than placebo) are going to be published, the company has every incentive in the world to just keep funding study after study until they finally get one that shows the result they want, not because it is a real result, but because of the natural variation and error that is part of research.  And these companies have the deep pockets to do that. So theoretically, they could fund 100 clinical trials and even if they only found a “significant” result in 1 out of 100 studies they ran, that one “significant” finding gets published in a journal, health care providers read about it, the press picks up on it, there are ads in magazines touting the positive findings, and now it’s the new wonder drug. However, the 99 other studies showed that drug “Y” was ineffective were never published.

From a consumer standpoint, would you purchase something if the advertisers told you that 99 times out of 100 it was shown to be completely ineffective? No, we’re more likely to buy (or in the case of health care providers, prescribe them to our patients) products when they are backed by claims like “Clinical studies prove that drug “Y” significantly reduced symptoms of X”. What the RIAT initiative will do is give us a more complete picture so that we can know about the studies that showed that a drug or other product was harmful or ineffective, versus only hearing about the studies that happen to work out.

Unfortunately, the RIAT initiative doesn’t have the ability to force drug companies or researchers to publish their negative findings. However, it does shine light on this incredibly important issue and, if the public demands it, will put new pressure on researchers and the industries to commit to making ALL their data available. This will allow researchers do what they are meant to do, be scientists, rather than being PR machines for companies with very deep pockets.

If I’ve convinced you here that this issue really does impact you and you’d like to read more about this problem of only publishing “significant” findings, you can read this great, in-depth article on the topic published in Scientific America.

You can also sign the petition to support the All Trial Registry here.

New Law in Oregon: Your Rights to Bereavement Leave

People who experience the loss of a loved one are often tasked with managing life insurance and legal issues, resolving financial paperwork, planning a funeral, and sorting through their loved one’s belongings. All of this often happens while they are in shock or otherwise facing great emotional distress. This is often a time to seek out help and support from friends, family, or elsewhere. Reasonable and compassionate employers is are happy to be flexible and find a solution that allows people to attend to their grief and practical matters while also honoring work obligations. Many businesses have bereavement policies already in place and this is really helpful for those people who need to take advantage of them.

While most employers are quite willing to be flexible with helping their employees manage major life events, in some cases there are also laws in place to help insure reasonable allowances are made. For example, the Family and Medical Leave Act helps ensure that people will be able to take off time from work to care for a newborn child or to help a family member with medical illness. However, there are relatively few laws in place to help people cope with the demands that can come with bereavement.

A notable exception can be found in the recently amended Family Leave laws of Oregon, which now includes bereavement as a major life event warranting protected leave. Oregon is the first state to enact this kind of law, which applies to businesses with more than 25 employees and which goes into effect in January 2014. According to this new law, people may take up to two weeks of bereavement leave to attend a funeral or memorial service of a family member, make any necessary arrangements, and to grieve. The bereavement leave can be taken up to 60 days after you have learned about the death, and it is also possible to take additional leave if you are faced with the loss of more than one family member.

While people rarely finish grieving in under two weeks, taking a little bit of time off often helps people have the space to bring their full attention and care to the practical and emotional process of grieving.

 

Dr. Paul Guinther is a licensed psychologist specializing in grief counseling at Portland Psychotherapy

Why See A Health Psychologist?

When a person has significant issues with their health it can bring many challenges, more than just how it affects their body.  Just like it is often helpful to see a physician who may prescribe a medication or perform a surgery, it can also be helpful to see a psychologist to learn skills to cope more effectively with the changes significant health problems bring.

 

Lots of people report that by learning to manage their illness more effectively their quality of life gets better.  This means that you can actively work on making your life better by focusing on how you handle the stress of your chronic illness.

What exactly is Health Psychology?

Clinical Health Psychology (also known as behavioral medicine) is a specialty within psychology that focuses on the unique issues that people struggling with physical illness encounter.  Health issues are much more than just a problem with the body. They often affect many areas of someone’s life, such as…

  • Your mood – how happy, sad, anxious or depressed you are
  • Your thoughts – how much you worry or are hopeless about the future
  • Your social life – how much you engage with the people special to you
  • Your work life – how able you are to perform a job

Health Psychology, for the most part, is an evidenced-based type of approach to therapy.  This means that I stay current on the latest research and use techniques that have been shown to work in the scientific literature.

What Is Treatment Like?

As a health psychologist my main goal is to help you manage your health condition and improve your quality of life.  Together, as a team, we figure out how to help you to live better both physically & mentally.

Because no two people are alike, treatment is tailored to the unique situation of each patient.  In general, my work with people tends to be more short-term & focused on specific problems.  Examples of common problems that a health psychologist can help with include :

  • having a hard time following doctor’s recommendations even though you want to
  • worrying so much about symptoms that you aren’t able to work like you used to
  • chronic pain that makes you feel irritable and so you end up pushing away the people that you care about
  • having so much anxiety about symptoms that your relationship suffers or you have given up on dating

We focus on the learning new skills, attitudes & behaviors (because surgery, injections & medications are not the only resources for treating chronic health issues).  With these changes you can be empowered to take a more active role in understanding and addressing your struggles with health.

Another way I can be helpful is by communicating with your other medical providers so that you and your whole medical team are all on the same page.

Who Benefits From This Type of Treatment?

This type of treatment can be particularly helpful for people who are struggling with symptoms of their illness that keep them stuck and not able to live their life the way they would like to.

Here is a list of common problems that health psychology is often effective in addressing:

  • Feeling depressed due to the changes health issues have caused
  • Overwhelming stress & worry about health
  • Feeling alone and without a support system
  • Seeing a physician much more frequently than they would like
  • Feeling overwhelmed about making medical decisions
  • Adjusting to life with a chronic health condition

These are the most common types of health problems people see a health psychologist for:

  • Headaches
  • Chronic pain
  • Anxiety disorders
  • Stress related disorders
  • Raynaud’s disease
  • Diabetes mellitus
  • Urinary incontinence
  • Irritable bowel syndrome (IBS)

Will my insurance pay for treatment with a health psychologist?

If your insurance has mental health coverage then yes, it will be covered under these benefits.  If you are unsure of what your coverage is you can call the phone number on the back of your insurance card or call us to see if we can help (503.281.4852).

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