By Danielle Vasserman, Ed.M., Psy.D., William James College, Newton, MA

Intro:

Technology has been a significant and even imperative part of daily life for most people. Computers, phones, tablets, and other “smart” devices have long since become mainstream and apply universally across all sectors of society, all cultures and ages. These devices keep us all constantly connected to the internet and to each other; making virtually any piece of information available to us at any time. Applications on computers and smart devices have digitized various services to make them more convenient. It often seems as though anything in life is already a ‘click’ away, despite the fact that numerous applications and programs are created daily providing services that seem necessary to the average consumer. As a growing number of services are increasingly becoming available online, it is only natural that health services follow suit….

 

Overview:

Providers from all fields have used technology professionally for years; beginning with the use of the computer for internal communication and later for electronic medical records. Likewise, therapists have also utilized phone calls to conduct therapy at a distance and “check in” on their patients in between office visits, when necessary. However, the nature of this discussion has come to change along with developments in the field of technology. The scope of technology in this day and age is vast and quickly growing and the mental health field has made some adaptations in this regard. In short, you can find just about anything online at this point! Today’s existing technology includes applications for both computers and wireless devices that complement or supplement treatment, websites that support talk therapy in various forms as well as various digitized manual based treatments that often supplement and, some argue also replace, face-to-face treatment. 

What is a Developmental Disorder?

A developmental disorder is a broader term encompassing several disorders. The Diagnostic and Statistical Manual, Fifth edition, (DSM 5), (2013) includes a new chapter about developmental disorders entitled, “Neurodevelopmental Disorders.” The new category includes intellectual disability (Intellectual Developmental Disorder), communication disorders, autism spectrum disorder, attention deficit hyperactivity disorder, specific learning disorder, and motor disorders.

What is Intellectual Disability?

An estimated 3 million Americans have intellectual and developmental disabilities.  Intellectual and developmental disabilities are usually present at birth and limit the growth trajectory of physical, intellectual, and/or emotional aspects of a person’s development.   The term developmental disabilities refers to a broad range of dysfunction in physical, intellectual, and emotional health.   

According to the DSM V (2013), Intellectual Disability can be diagnosed until approximately age 18, and determines a person’s cognitive, intellectual, and practical abilities to perform daily functions. In 2002, the American Association on Mental Retardation listed criteria for diagnosing intellectual disability by identifying factors to assess and inform treatment for intellectual disability.  These factors included limitations in functioning, valid assessment across cultural and linguistic backgrounds, and identifying the type(s) of disabilities in order to find providers who can improve daily functioning.

What is Forensic Psychology?

Forensic psychology is the combination of law and psychology. It is the application of psychology within a wide range of legal contexts. These include: civil (non-criminal) matters such as child custody proceedings in divorce, guardianships, personal injury lawsuits, child requiring assistance (CRA), and involuntary civil commitments to psychiatric units; criminal matters such as competence to stand trial, criminal responsibility, or aids in sentencing; juvenile delinquency or youthful offender matters where youth are charged with crimes; and administrative law proceedings such as special education appeals or licensure complaints against professionals.

Why might you need a Forensic Psychologist?

One role of the forensic psychologist is to provide forensic evaluations to the court.  Forensic evaluations commonly address nonclinical issues as any clinical issues presented tend to serve as background information.  The client will often enter into a forensic evaluation as mandated by a judge or court and, as findings will be submitted to a court of law, it is of optimal importance for the forensic psychologist to determine accuracy of the client’s report.  Forensic evaluations tend to be less treatment-oriented and occur over a shorter period of time due to time constraints set by the court or judge.

Attorneys have wide discretion to choose whom they wish for experts to assist them in a case. In certain kinds of civil or criminal cases, Massachusetts courts ordering evaluations must rely upon a Designated Forensic Psychologist (DFP) in District or Superior Court cases, or a Certified Juvenile Court Clinicians (CJCC) in Juvenile Court cases. Massachusetts requires a certification as a Designated Forensic Psychologist in order to serve in a public sector forensic mental health position.

Use of Apps for Mental Health and Wellness

Many people experience barriers to receiving mental health treatment. Whether it is a busy schedule, transportation problems, or financial concerns, it can be difficult to maintain consistent appointments with a mental health provider. Below is a list of helpful mental health applications that can be used on your mobile device. Many of them are free for users, and the rest are purchasable for a small fee.  These applications help with a range of mental health needs – including maintaining daily balance and wellness, reducing stress, and reinforcing concepts related to treatment.   

Demographic Profile of The U.S. Immigrant and Refugee Population

Immigrants and Refugees in the United States make up a unique subset of the country’s population.  According to 2016 data, The U.S. immigrant population stood at nearly 44 million million, or 13.5 percent, of the total U.S. population of 323.1 million.  Of this population, immigrants in the United States and their U.S.-born children now number approximately 86.4 million people, or 27 percent of the overall U.S. population (Zong, & Batalova, 2018).  Out of this large number of immigrants to the United States, 46 percent of the foreign-born population in 2016 reported their race as white, 45 percent of immigrants reported having Hispanic or Latino origins, 27 percent as Asian, 9 percent as black, and 15 percent as some other race, and more than 2 percent reported having two or more races (Zong, & Batalova, 2018).  Furthermore, in 2016, 18 million children ages 18 and younger lived with at least one immigrant parent, which accounts for 26 percent of the 70 million children under age 18 in the United States  (Zong, & Batalova, 2018).  Thus, it is estimated that, by the year 2020, one in three children below the age of 18 will be the child of an immigrant (Working with Immigrant-Origin Clients, 2013). Thus, with the increases in immigrant and refugee populations to the U.S. over the years, the country continues to diversify.  A breakdown of the growth in immigrant populations within the U.S. is outlined in the table below.

Numerical Size and Share of the Foreign-Born Population in the United States, 1970-2014

More than 33,000 Americans die by suicide each year—the equivalent of one suicide every 16 minutes. There may be as many as 25 suicide attempts for every death by suicide. Suicide can be attempted by individuals of any age.  In fact, suicide is currently the third-leading cause of death among adolescents in the United States, and the fourth-leading cause among preteens. More than 15 percent of high school students report that they have seriously contemplated suicide, while even more experience thoughts about suicide at one time or another.  Furthermore, the highest suicide rate of any age group occurs among older adults (American Association of Suicidology, 2009).  One consideration for this is that as individuals grow older, they may experience one or more physical illnesses - and physical illness can increase an older adult’s risk for depression and/or suicidal ideation.

Indeed, the majority of individuals who attempt suicide have a diagnosable mental health condition such as depression, bipolar disorder, or substance dependence.  Research shows that older adults suffering from depression and/or experiencing suicidal thoughts are not likely to seek psychiatric care (Conwell, 1993). However, data indicates that older adults contemplating suicide may well have visited a primary care doctor but the signs and symptoms of suicide have gone unnoticed.  Suicide is preventable if such conditions are recognized and treated, and if warning signs are taken seriously. Indeed, former Surgeon General David Satcher (who issued the first National Strategy for Suicide Prevention) described several ways in which suicide could be prevented in his Call to Action to Prevent Suicide (1999).

Certain events in a person’s individual or family history can also put that person at increased risk of attempting suicide.  According to the Center for Disease Control and Prevention (CDC), these risk factors - for any age - include:

Nonsuicidal self-injury (NSSI) is the deliberate act of harming oneself without suicidal intent. Some of the most common self-injurious behaviors include cutting, scratching, and/or burning one’s skin. NSSI could also involve intentionally injuring one’s own body by other means with the intent to inflict pain (e.g. head banging, skin picking and/or substance use to the point of harming oneself such as via overdose).  Individuals who engage in NSSI can harm themselves anywhere on their bodies. Yet, some of the most common places where individuals engage in NSSI are on the hands, wrists, stomach, and thighs.

Although NSSI may appear like a suicidal gesture, self-injury is often an individual’s effort to cope with overwhelming negative emotions, such as intense anger, sadness, anxiety, and frustration. Engaging in self-injury is not the same as feeling suicidal, but individuals who engage in NSSI can become suicidal. In fact, individuals who self-injure are at greater risk for attempting suicide.  Self-injury can result in a temporary release of tension and sometimes a feeling of euphoria, which may be later followed by feelings of guilt, shame and other painful emotions. Although NSSI does not necessarily indicate that an individual is feeling suicidal, NSSI can be severe enough to where it results in death. An individual may be numb to any pain as they self-injure, which could also result in the individual causing more harm during the self-injury than they realized and/or intended to.

Looking for Support?

See our list of PPD support groups in Massachusetts. Please check with the listed organization for participant openings and registration details.

Welcome to motherhood! Your baby has arrived, and you may be faced with a myriad of feelings – happiness, relief, hope, as well as worries, exhaustion, and uncertainty. Motherhood brings multiple demands and expectations. You are expected to be a good mother – one that is responsive to her child, knows how to comfort and nurture her baby. But what if you don't feel at all comfortable? What if you feel sad and exhausted and not sure about what to do for your baby? If you are feeling this way, you are definitely not alone. It is not unusual for new moms to feel sad, tired and unsure of their parenting skills. In fact, many new moms go through these feelings, and as many as 80% may experience the "baby blues." Baby blues are characterized by periods of crying for no apparent reason, anxiety, difficulty sleeping, and restlessness. For many women, these symptoms usually diminish approximately within 10-12 days after delivery.

For some women, however, these feelings may persist and even increase over time. This is no longer part of the “baby blues,” but may signal a more serious illness. While the most commonly known emotional disorder is post-partum depression, there are actually a number of emotional complications that may occur both during and after pregnancy.  These disorders are called perinatal emotional disorders.  Below is a brief description of each.