Drowning in Debris: A Daughter Faces Her Mother’s Hoarding

Deborah Derrickson Kossmann

Psychotherapy Networker

March/April 2023

Here is an excerpt:

My job as a psychologist is to salvage things, to use the stories people tell me in therapy and help them understand themselves and others better. I make meaning out of the joy and wreckage of my own life, too. Sure, I could’ve just hired somebody to shovel all my mother’s mess into a dumpster, but I needed to be my family’s archaeologist, excavating and preserving what was beautiful and meaningful. My mother isn’t wrong to say that holding on to some things is important. Like her, I appreciate connections to the past. During the cleaning, I found photographs, jewelry passed down over generations, and my bronzed baby shoes. I treasure these things.

“Maybe I failed by not following anything the psychology books say to do with a hoarding client,” I tell my sister over the phone. “Sometimes I still feel like I wasn’t compassionate enough.”

“You handled it as best you could as her daughter,” my sister says. “You’re not her therapist.”

After six years, my mother has finally stopped saying she’s a “prisoner” at assisted living. She tells me she’s part of a “posse” of women who eat dinner together. My sister decorated her studio apartment beautifully, but the cluttering has begun again. Piles of magazines and newspapers sit in corners of her room. Sometimes, I feel the rage and despair these behaviors trigger in me. I still have nightmares where I drive to my mother’s house, open the door, and see only darkness, black and terrifying, like I’m looking into a deep cave. Then, I’m fleeing while trying to wipe feces off my arm. I wake up feeling sadness and shame, but I know it isn’t my own.

A few weeks ago, I pulled up in front of my mother’s building after taking her to the cardiologist. We turned toward each other and hugged goodbye. She opened the car door with some effort and determinedly waved off my help before grabbing the bag of books I’d brought for her.

“I can do it, Deborah,” she snapped. But after taking a few steps toward the building entrance, she turned around to look at me and smiled. “Thank you,” she said. “I really appreciate all you do for me.” She added, softly, “I know it’s a lot.”

The article is here.

The article is an important reminder that practicing psychologists cope with their own stressors, family dynamics, and unpleasant emotional experiences.  Psychologists are humans with families, value systems, emotions, beliefs, and shortcomings.

The COVID-19 era: How therapists can diminish burnout symptoms through self-care

Rokach, A., & Boulazreg, S. (2020). 

Current psychology,1–18. 

Advance online publication. 

https://doi.org/10.1007/s12144-020-01149-6

Abstract

COVID-19 is a frightening, stress-inducing, and unchartered territory for all. It is suggested that stress, loneliness, and the emotional toll of the pandemic will result in increased numbers of those who will seek psychological intervention, need support, and guidance on how to cope with a time period that none of us were prepared for. Psychologists, in general, are trained in and know how to help others. They are less effective in taking care of themselves, so that they can be their best in helping others. The article, which aims to heighten clinicians’ awareness of the need for self-care, especially now in the post-pandemic era, describes the demanding nature of psychotherapy and the initial resistance by therapists to engage in self-care, and outlines the consequences of neglecting to care for themselves. We covered the demanding nature of psychotherapy and its grinding trajectory, the loneliness and isolation felt by clinicians in private practice, the professional hazards faced by those caring for others, and the creative and insightful ways that mental health practitioners can care for themselves for the good of their clients, their families, and obviously, themselves.

Here is an excerpt:

Navigating Ethical Dilemmas

An important impact of competence constellations is its aid to clinicians facing challenging dilemmas in the therapy room. While numerous guidelines and recommendations based on a code of ethics exist, real-life situations often blur the line between what the professional wishes to do, rather than what the recommended ethical action is most optimal to the sovereignty of the client. Simply put, “no code of ethics provides a blueprint for resolving all ethical issues, nor does the avoidance of violations always equate with ideal ethical practice, but codes represent the best judgment of one’s peers about common problems and shared professional values.” (Welfel, 2015, p. 10).

As the literature asserts—even in the face of colleagues acting unethically, or below thresholds of competence, psychologists don’t feel comfortable directly approaching their coworkers as they feel concerned about harming their colleagues’ reputation, concerned that the regulatory board may punish their colleague too harshly, or concerned that by reporting a colleague to the regulatory board they will be ostracized by their colleagues (Barnett, 2008; Bernard, Murphy, & Little, 1987; Johnson et al., 2012; Smith & Moss, 2009).

Thus, a constellation network allows a mental health professional to provide feedback without fear of these potential repercussions. Whether it is guised under friendly advice or outright anonymous, these peer networks would allow therapists to exchange information knowingly and allow for constructive criticism to be taken non-judgmentally.

The info is here.

Birmingham psychologist defrauded state Medicaid of more than $1.5 million, authorities say

Carol Robinson

Sharon Waltz

al.com
Originally published August 15, 2019

A Birmingham psychologist has been charged with defrauding the Alabama Medicaid Agency of more than $1 million by filing false claims for counseling services that were not provided.

Sharon D. Waltz, 50, has agreed to plead guilty to the charge and pay restitution in the amount of $1.5 million, according to a joint announcement Thursday by Northern District of Alabama U.S. Attorney Jay Town, Department of Health and Human Services -Office of Inspector General Special Agent Derrick L. Jackson and Alabama Attorney General Steve Marshall.

“The greed of this defendant deprived mental health care to many at-risk young people in Alabama, with the focus on profit rather than the efficacy of care,” Town said. “The costs are not just monetary but have social and health impacts on the entire Northern District. This prosecution, and this investigation, demonstrates what is possible when federal and state law enforcement agencies work together.”

The info is here.

Taking Ethics Seriously: Toward Comprehensive Education in Ethics and Human Rights for Psychologists

Duška Franeta
European Psychologist (2019), 24, pp. 125-135.

Education in ethics and professional regulation are not alternatives; education in ethics for psychologists should not be framed merely as instruction regarding current professional regulation, or “ethical training.” This would reduce ethics to essentially a legal perspective, diminish professional responsibility, debase professional ethics, and downplay its primary purpose – the continuous critical reflection of professional identity and professional role. This paper discusses the meaning and function of education in ethics for psychologists and articulates the reasons why comprehensive education in ethics for psychologists should not be substituted by instruction in professional codes. Likewise, human rights education for psychologists should not be downgraded to mere instruction in existing legal norms. Human rights discourse represents an important segment of the comprehensive education in ethics for psychologists. Education in ethics should expose and examine substantial ethical ideas that serve as the framework for the law of human rights as well as the interpretative, multifaceted, evolving, even manipulable character of the human rights narrative. The typically proclaimed duty of psychologists to protect and promote human rights requires a deepening and expounding of the human rights legal framework through elaborate scrutiny of its ethical meaning. The idea of affirming and restoring human dignity – the concept often designated as the legal and ethical basis, essence, and purpose of human rights – represents one approach to framing this duty by which the goals of psychology on the professional and ethical levels become unified.

The info is here.

Atlanta child psychologist admits to molesting girl, posting it online

Ben Brasch and Kristal Dixon
The Atlanta Journal-Constitution
Originally posted February 15, 2019

A metro Atlanta psychologist who spent years counseling children will spend two decades in prison after violating the trust of those around him and molesting a pre-teen girl.

In a muffled voice, Jonathan Gersh, 38, admitted in a Cobb County court Friday that he took lewd pictures of the girl, which he put online and were viewed around the world.

Prosecutors said he also took cell phone pictures of children in bathing suits in public and offered to trade photos online. “These pictures are not baseball cards to be traded,” said Judge Steven Schuster.

Gersh’s charges included child molestation and child pornography, but Schuster said “I have a duty to the victim, the victim’s family and society to stop any form of what I perceive to be sex trafficking.”

Defense attorney Richard Grossman had asked the judge for five years in prison. Prosecutors asked for 18 years. Grossman said described his client’s actions as compulsive “voyeurism” and said Gersh “led an exemplary life” as a loving father who offered pro bono counseling to the community.

The info is here.

Cheyenne Psychologist And His Wife Sentenced To 37 Months In Prison For Health Care Fraud

Department of Justice
U.S. Attorney’s Office
District of Wyoming
Press Release of December 4, 2018

John Robert Sink, Jr., 68, and Diane Marie Sink, 63, of Cheyenne, Wyoming, were sentenced on December 3, 2018, to serve 37 months in prison for making false statements as part of a scheme to fraudulently bill Wyoming Medicaid for mental health services, which were never provided, announced United States Attorney Mark A. Klaassen. The Sinks, who are married, were also ordered to pay over $6.2 million in restitution to the Wyoming Department of Health and the United States Department of Health and Human Services, and to forfeit over $750,000 in assets traceable to the fraud, including cash, retirement accounts, vehicles, and a residence.

The Sinks were indicted in March 2018 by a federal grand jury for health care fraud, making false statements, and money laundering. At all times relevant to the indictment, John and Diane Sink operated a psychological practice in Cheyenne. John Sink, who was a licensed Ph.D. psychologist, directed mental health services. Diane Sink submitted bills to Wyoming Medicaid and managed the business and its employees. The Sinks provided services to developmentally disabled Medicaid beneficiaries and billed Medicaid for those services.

Between February 2012 and December 2016, the Sinks submitted bills to Wyoming Medicaid for $6.2 million in alleged group therapy. These bills were false and fraudulent because the services provided did not qualify as group therapy as defined by Wyoming Medicaid. The Sinks also falsely billed Medicaid for beneficiaries who were not participating in any activities, and therefore did not receive any of the claimed mental health services. When Wyoming Medicaid audited the Sinks in May 2016, the Sinks did not have necessary documentation to support their billing, so they ordered an employee to create backdated treatment plans. The Sinks then submitted these phony treatment plans to Wyoming Medicaid to justify the Sinks’ false group therapy bills, and to cover up their fraudulent billing scheme.

The pressor is here.

Prison for psychologist had sex with patients

Perrin Stein
Gillette News Record
Originally published January 12, 2018

It was standing room only in the courtroom as dozens of people gathered Thursday afternoon to see a former Gillette psychologist sentenced to prison for sexually assaulting two patients.

“During my brief time as a therapist, I did more harm than good and acted in ways that will reverberate in these women’s lives for years to come,” Joshua Popkin, 33, said before being taken into custody to serve two consecutive three- to five-year prison sentences for two counts of second-degree sexual assault.

Popkin met the two patients while interning at Campbell County Health in 2015.

One of the patients was seeking treatment for mental health issues related to a previous rape by an assailant elsewhere, according to court documents. After treating her at CCH, he saw her at his private practice, where he made increasingly sexual advances toward her. In June 2016, he had forced sex with her, according to court documents.

The article is here.

Disturbing allegations against psychologist at VT treatment center

Jennifer Costa
WCAX.com
Originally published November 17, 2017

Here is an excerpt:

Simonds is accused making comments about female patients, calling them "whores" or saying they look "sexy" and asking inappropriate details about their sex lives. Staff members allege he showed young women favoritism, made promises about drug treatment and bypassed waiting lists to get them help ahead of others.

He's accused of yelling and physically intimidating patients. Some refused to file complaints fearing he would pull their treatment opportunities.

Staffers go on to paint a nasty picture of their work environment, telling the state Simonds routinely threatened, cursed and yelled at them, calling them derogatory names like "retarded," "monkeys," "fat and lazy," and threatening to fire them at will while sexually harassing female subordinates.

Co-workers claim Simonds banned them from referring residential patients to facilities closer to their homes, instructed them to alter referrals to keep them in the Maple Leaf system and fired a clinician who refused to follow these orders. He is also accused of telling staff members to lie to the state about staffing to maintain funding and of directing clinicians to keep patients longer than necessary to drum up revenue.

The article is here.

Psychologist felt 'honest, sincere' before $800K healthcare fraud exposed

John Agar
MLive.com
Originally posted November 21, 2017

A psychologist who defrauded insurance companies of $800,000 spent half of the money on vacations, concert tickets and a mobile-recording business, the government said.

George E. Compton Jr., 63, of Sturgis, was sentenced by U.S. District Judge Gordon Quist to 28 months in prison.

Compton, who pleaded guilty to healthcare fraud, said he was "ashamed" of his actions.

"Until this investigation, I did not hesitate to describe myself as an honest, sincere man," he wrote in a letter to the judge. "Seeing myself from a different perspective has been trying to say the least. ... The worst punishment for my admitted crimes will be the exclusion from the very work I love."

The government said he billed insurance companies for counseling sessions he did not provide, from Jan. 1, 2013, until June 30, 2016.

The article is here.

Henderson psychologist charged with murder can reopen practice

David Ferrara
Las Vegas Review-Journal
Originally posted July 14, 2017

A psychologist accused of killing his wife and staging her death as a suicide can start practicing medicine again in less than four months, the Nevada Board of Psychological Examiners decided Friday.

Suspected of abusing drugs and obtaining prescription drugs from patients, Gregory “Brent” Dennis, who prosecutors say poisoned attorney Susan Winters inside their Henderson home, also must undergo up to seven years of drug treatment, the seven-member panel ruled as they signed a settlement agreement that made no mention of the murder charge.

“It’s clear that the board members do not know what Brent Dennis was arrested for,” Keith Williams, a lawyer for the Winters family, told a Las Vegas Review-Journal reporter after the meeting. “We’re confident that they did not know what they were voting on today.”

Henderson police arrested Dennis on the murder charge in February.

The article is here.

Psychologists Open a Window on Brutal C.I.A. Interrogations A Lawsuit Filed on Behalf of Former Prisoners Reveals New Details

Sheri Fink & James Risen
The New York Times
Originally posted June 21, 2017

Fifteen years after he helped devise the brutal interrogation techniques used on terrorism suspects in secret C.I.A. prisons, John Bruce Jessen, a former military psychologist, expressed ambivalence about the program.

He described himself and a fellow military psychologist, James Mitchell, as reluctant participants in using the techniques, some of which are widely viewed as torture, but also justified the practices as effective in getting resistant detainees to cooperate.

“I think any normal, conscionable man would have to consider carefully doing something like this,” Dr. Jessen said in a newly disclosed deposition. “I deliberated with great, soulful torment about this, and obviously I concluded that it could be done safely or I wouldn’t have done it.”

The two psychologists — whom C.I.A. officials have called architects of the interrogation program, a designation they dispute — are defendants in the only lawsuit that may hold participants accountable for causing harm.

The program has been well documented, but under deposition, with a camera focused on their faces, Drs. Jessen and Mitchell provided new details about the interrogation effort, their roles in it and their rationales. Their accounts were sometimes at odds with their own correspondence at the time, as well as previous portrayals of them by officials and other interrogators as eager participants in the program.

The article is here.

Judge Allows Lawsuit Against Psychologists in C.I.A. Torture Case

Sheri Fink
The New York Times
Originally published January 29, 2017

A federal judge on Friday allowed a case brought by former detainees to move forward against two American psychologists who helped devise the C.I.A.’s now-defunct program to interrogate terrorism suspects using techniques widely considered to be torture.

A United States District Court judge, Justin L. Quackenbush, denied a motion by the psychologists that sought to dismiss the case for lack of jurisdiction under provisions of a 2006 law that limits the ability of detainees to challenge their treatment.

“This ruling sends the strong signal that anyone who participates in shameful and unlawful government torture can’t count on escaping accountability in a court of law,” said Dror Ladin, a staff attorney for the American Civil Liberties Union, which, with the Gibbons law firm in Newark, represents the former detainees.

The article is here.

Lawsuit Aims to Hold 2 Contractors Accountable for C.I.A. Torture

By Sheri Fink and James Risen
The New York Times
Originally posted on November 27, 2016

Here is an excerpt:

Dr. Mitchell was first publicly identified as one of the architects of the C.I.A.’s “enhanced interrogation” program nearly a decade ago, and has given some news media interviews, but is now providing a more detailed account of his involvement. His book, “Enhanced Interrogation: Inside the Minds and Motives of the Islamic Terrorists Trying to Destroy America” (Crown Forum), was written with Bill Harlow, a former C.I.A. spokesman. It was reviewed by the agency before release. (The New York Times obtained a copy of the book before its publication date.)

In the book, Dr. Mitchell alleges that harsh interrogation techniques he devised and carried out, based on those he used as an Air Force trainer in survival schools to prepare airmen if they became prisoners of war, protected the detainees from even worse abuse by the C.I.A.

Dr. Mitchell wrote that he and Dr. Jessen sequestered prisoners in closed boxes, forced them to hold painful positions for hours and prevented them from sleeping for days. He also takes credit for suggesting and implementing waterboarding — covering a detainee’s face with a cloth and pouring water over it to simulate the sensation of drowning — among other now-banned techniques. “Although they were unpleasant, their use protected detainees from being subjected to unproven and perhaps harsher techniques made up on the fly that could have been much worse,” he wrote. C.I.A. officers, he added, “had already decided to get rough.”

The article is here.

Editor's note: If you think torture works, please read: Why Torture Doesn’t Work: The Neuroscience of Interrogation, by Shane O'Mara.

Why does imprisoned psychologist still have license to practice?

Charles Keeshan and Susan Sarkauskas
Chicago Daily Herald
Originally published November 11, 2016

Here is an excerpt:

Federal prosecutors said Rinaldi submitted phony bills to Medicare for about $1.1 million over four years, collecting at least $447,155. In nearly a dozen instances, they said, she submitted claims indicating she had provided between 35 and 42 hours of therapy in a single day. In others, she submitted claims stating she had provided care to Chicago-area patients when she was actually in San Diego or Las Vegas.

The article is here.

Prep school abuse victims file complaints about psychologist

by Michelle R. Smith
Associated Press
Originally published September 8, 2016

Two victims of sexual abuse at the elite Rhode Island boarding school St. George's have filed complaints with state licensing officials about the school's former psychologist.

They tell The Associated Press that Peter Kosseff did not do enough to address and prevent abuse during his 35 years at the school, and they want his license revoked.

Kosseff, who still practices and has offices in South Kingstown and Newport, did not respond to multiple requests for comment.

The first complaint was filed in December and the other soon after, the two women told the AP.  Joseph Wendelken, a spokesman for the Department of Health, which oversees such licenses, said such complaints are confidential and he could not confirm them. The department said Kosseff's license was last renewed in May.

The Associated Press typically doesn't name sexual abuse victims unless they come forward publicly.

The article is here.

Thoughts on Psychologists, Ethics, and the Use of Torture in Interrogations

Zimbardo, P.G. (2007). Thoughts on Psychologists, Ethics, and the Use of Torture in  Interrogations: Don’t Ignore Varying Roles and Complexities.
Analyses of Social Issues and Public Policy (ASAP) Online SSPSI Journal. Vol. 7, pp. 65-73.

Here is an excerpt:

Such considerations lead me to conclude that PENS has utilized the wrong model for its ethical deliberations about psychologists as consultants to military interrogations. The model featured in this task force report is that of a psychologist working for the military as an independent contractor, making rational moral decisions within a transparent setting, with full power to confront, challenge and expose unethical practices. It is left up to that individual to be alert, informed, perceptive, wise, and ready to act on principle when ethical dilemmas arise.

Instead, I will argue that those psychologists are "hired hands" working at the discretion of their military or government agency clients for as long as they provide valued service, which in the current war on terrorism is to assist by providing whatever information and advice is requested to gain "actionable intelligence" from those interrogated. PENS notes that psychologists often are part of a group of professionals, rarely acting alone. They can become part of an operational team, experiencing normative pressures to conform to the emerging standards of that group. They cannot make readily informed ethical decisions because they do not have full knowledge of how their personal contributions are being used in secret or classified missions. Their judgments and decisions may be made under conditions of uncertainty, and may include high stress. Moreover, definitions of basic terms are not constant, but shifting, so it becomes difficult or impossible to make a fully informed ethical judgment about any specific aspect of one's functions.

In addition, PENS does not recognize the reality that in field settings, the work of Ph.D./Psy.D. psychologists is often substituted by, or made operational by, numerous paraprofessionals, such as mental health counselors, personnel officers, psychological assistants and interns, and others trained in psychology. If they do not belong to professional associations, such as APA, they are relieved of the professional consequences of engaging in unethical actions. Thus, our concerns must extend to these psychologist paraprofessionals as well as those professionals within APA.

The entire article is here.

Episode 22: Ethics and Skills for Psychologist as Supervisor-Post-Doctoral Supervision

Podcasts 21, 22, and 23 will provide supervisors and supervisees with an understanding of the skills and ethical issues surrounding supervision, including the Pennsylvania State Board of Psychology’s Regulations dealing with postdoctoral supervision. The workshop will review the basic requirements for ethical supervision, common pitfalls, and give supervisors an understanding of the requirements that must be met for obtaining post-doctoral supervision.

In this episode, John's guest is John Jay Mills, Ph.D., ABPP, a psychologist and professor at Indiana University of Pennsylvania, and Samuel J. Knapp, Ed.D., ABPP, psychologist and Professional Affairs Officer at the Pennsylvania Psychological Association.

At the end of the podcast series the participants will be able to:

1.  Describe essential factors involved in ethically sound and effective supervision;
2.  List or identify the State Board of Psychology requirements for post-doctoral supervision.
3.  Explain ways to improve supervisee's level of competence, self-reflection, and professionalism; &
4.  Identify strategies to comply with the Pennsylvania State Board of Psychology regulations on supervision of post-doctoral trainees.



The associated SlideShare presentation can be found here.

The YouTube video can be found here.

PA § 41.33. Supervisor requirements

PA § 41.32. Experience qualifications to become a psychologist

Verification of Post-doctoral Experience from the Pennsylvania State Board of Psychology

Episode 21: Ethics and Skills for Psychologist as Supervisor-Post-Doctoral Supervision

Podcasts 21, 22, and 23 will provide supervisors and supervisees with an understanding of the skills and ethical issues surrounding supervision, including the Pennsylvania State Board of Psychology’s Regulations dealing with postdoctoral supervision. The workshop will review the basic requirements for ethical supervision, common pitfalls, and give supervisors an understanding of the requirements that must be met for obtaining post-doctoral supervision.  

In this episode, John's guest is John Jay Mills, Ph.D., ABPP, a psychologist and professor at Indiana University of Pennsylvania.

At the end of the podcast series the participants will be able to:

1.  Describe essential factors involved in ethically sound and effective supervision;
2.  List or identify the State Board of Psychology requirements for post-doctoral supervision;
3.  Explain ways to improve supervisee's level of competence, self-reflection, and professionalism; &
4.  Identify strategies to comply with the Pennsylvania State Board of Psychology regulations on supervision of post-doctoral trainees. 

The associated SlideShare presentation can be found here.

Link to the YouTube Video here.

PA § 41.33. Supervisor requirements

PA § 41.32. Experience qualifications to become a psychologist

Verification of Post-doctoral Experience from the Pennsylvania State Board of Psychology

For one VA whistleblower, getting fired was too much

By Donovan Slack
http://www.wausaudailyherald.com
Originally posted April 12, 2015

Here are two excerpts:

There, officers found the body of Christopher Kirkpatrick, a 38-year-old clinical psychologist who had shot himself in the head after being fired from the Tomah Veterans Affairs Medical Center.

Kirkpatrick had complained some of his patients were too drugged to treat properly, but like other whistleblowers at the facility, he was ousted and his concerns of wrongdoing were disregarded.

Retaliation against whistleblowers has become a major problem at VA facilities across the country. The U.S. Office of Special Counsel is investigating 110 retaliation claims from whistleblowers in 38 states and the District of Columbia.

(cut)

VA officials said since Kirkpatrick's death, the agency has implemented online whistleblower training for 32,000 managers and executives at the agency, and now requires all employees to take a course every other year that includes a component about whistleblower rights. VA spokeswoman Genevieve Billia said notices of termination should contain language informing the affected employee of those rights. She did not respond to a message asking if that was mandatory.

The entire article is here.

Batgirl's Psychologist

By applying characters' fictional psyches to real-life problems, a cosplay enthusiast turned a passion for comic books into a mental-health career.

Erika Hayasaki
The Atlantic
Originally published January 27, 2015

Here is an excerpt:

Despite her excellent credentials and high grades, she carried with her traces of imposter syndrome—the fear that colleagues would discover she wasn’t smart or talented enough to be in her position. It is an anxiety that many career-driven women who excel in their fields experience, as noted in a famous 1978 study in Psychotherapy Theory, Research, and Practice, in which observations of 150 highly successful women found that they often thought of themselves as frauds and did not “experience an internal sense of success.”

The entire article is here.