Social Loafing

“Our life always expresses the result of our dominant thoughts.”
~ Soren Kierkegaard
     We have a special “Pizza Timer” in our house. If we’re cooking a frozen pizza, the easiest way to know when it’s done is to listen for the ear-piercing sound of the smoke detector. Then we figured out how to set a timer on the oven and the smoke detector/timer became superfluous. So we simply take the smoke detector off the wall and set it under the TV until the pizza is done cooking. 
   
    But sometimes, every once in awhile, we forget to to put the smoke detector back up. It eventually goes back up, but it may take a few days. My wife and I will walk by the smoke detector, clearly visible under the TV, and just…not put it back where it goes. For those few days, our early warning systems to help protect us from dying in a fire are greatly hampered. Before you go writing angry letters, you should know each room has its own smoke detector, we have a fire extinguisher in the kitchen, and we have a combination smoke/CO2 detector in the same area as the smoke detector we take down. Still….why don’t we put it back up? 
    Psychologists have a term for this; it’s called social loafing. Social loafing occurs when a group of people believe someone else will do the work/right thing/call the police/whatever, so we assume we don’t have to do it. If you have never experienced this, then you’ve never had to do a group project!
   There have been several experiments done to explain social loafing. My favorite is the pencil test: Get on an elevator with one other person and drop a pencil. There’s a pretty good chance they’ll try to pick it up. Drop a pencil in a crowded elevator and the chances of someone picking up that pencil drops drastically. For more information on the experiment, check out THIS LINK
    The idea of social loafing can have drastic real world implications. The story of Kitty Genovese is a tragic example of what can happen when a group of people believe someone else will take care of the problem, do the right thing, or call the police, or stop someone from doing the wrong thing. This is why, when someone needs to receive CPR, you should point to a particular individual and request they call 911. If you shout out, to a room full of people, “Someone call 911!”, there’s a significant chance no one will be called.

    Existential therapy offers a solution for social loafing: personal accountability. It’s very common for people to demand others be more accountable. But if we’re honest with ourselves, many times we’re actually saying, “Take responsibility for this so I don’t have to.” The personal accountability of one person neither decreases nor increases our personal accountability. Louis Hoffman wrote “Self-acceptance too often is intertwined with attempts to rationalize ourselves as being right or justified in our mistakes instead of embracing our humanity as imperfect creatures. Authentic self-acceptance requires that we are honest with ourselves about responsibility. Instead of seeking to justify our mistakes, we embrace them” (A Cultural Crisis of Responsibility: Responding to a Denial of Our Humanity).

    Waiting for someone else to take responsibility for a situation is a way to ensure we have no responsibility. In order to become more empowered we are forced to accept responsibility for the things we have done, and the things we have left undone. By no means should this imply that everything is our fault; far from it. But it does mean that if we want the world we live in to be better, we can no longer wait for others to make changes.

    The reason the smoke detector doesn’t go back up where it belongs is, ultimately, because I don’t put it back. As tumultuous as our country is currently, there are many situations and people who deserve to have fingers pointed at them. If I am not willing to point that finger at myself and begin asking what I can do, I only serve to give away my power.

Smoke Detector
(C) 2018 Nathan D. Croy

Running on Empty

“Without the ability to assert ourselves, we will have difficulty living with integrity and self-respect. Sacrificing our rights usually trains others to mistreat us. By standing up for our rights, we should we respect ourselves and thus win the respect of others.”
~Rollo May, Power and Innocence

     Has this ever happened to you? Trying to squeeze one more trip out of those last few drops of fuel is, for some people, a wonderful hobby! They know EXACTLY how far that gauge can move before the car is actually out of gas.

     In a former life, I worked in an autoshop, and saw cars come in with complaints of decreased performance, chugging, or not even starting. Turns out, many cars have their fuel pump located inside the gas tank. This does several things: the gas keeps the pump from overheating, there’s less contamination, and there’s less chance of exposure to air rusting out the fuel pump. This also means that, if you constantly run your tank low, you risk overheating your pump, clogging the filter with sediment from the tank (usually that stuff just sinks to the bottom and doesn’t bother the pump), and shortening the overall lifespan with added stress.

     We’re much more complex than cars, but there are certainly some similarities! Do you have warning lights that let you know when you’re running low? Do you find that trying to squeeze out “one more trip” when physical, emotional, or psychological resources are drained is shortening your lifespan? Does it inhibit your performance?

     Then find ways to refill! Make sure you are taking care of you! Sometimes it only takes a few minutes of rest, relaxation, meditation, or conversation. Whatever it is, don’t put it off until after you do one more thing!

     If you’re struggling to find a way to fill-up, give us a call! One of our therapists can work with you and your family to ensure you see finding ways to fully engage in life!

888.631.EXFT (3938)

Running on E
(c) 2018, Nathan D. Croy

Embrace The Trauma

“Anxiety is freedom’s possibility…”
~The Concept of Anxiety by Soren Kierkegaard
     I’m horrible at golf. I am my own hazard. It’s bad. However, I really enjoy it! Playing reminds me of spending time with my dad and I’ve found it to be relaxing. When I was beginning, my father would stand behind me and offer helpful critiques on my swing. 
    During a particularly horrendous game, the first four hits had immediately veered right as soon as my club made contact. I was frustrated. It made no sense to me why the ball wasn’t going where I was aiming! So, on the fifth hole, I lined my shot up to go far left of the green. It made sense that, if my shots went to the right, then I’d aim left and they’d go where I wanted!
     Standing behind me, my father piped up and pointed out that I was putting a foursome in some real jeopardy based on how I was lined up. I explained my reasoning of “ball goes right; aim left”. He chuckled and offered some advice, “We don’t change our game to match our mistakes; we fix our mistakes.”
     Many people who have experienced trauma tend to change their life to avoid future trauma. If they have been in an abusive relationship, they may decide all intimacy is potentially hurtful and not worth the risk. If they have been in a car accident, then they may decide leaving home is no longer worth the risk. They begin to change their life to match their trauma, instead of addressing the trauma. 
     This empowers the trauma and minimizes the power in the person. Changing our lives to match the trauma only serves to keep us stuck in the trauma. There is an increase in anxiety when we begin to think of confronting the trauma. This can be uncomfortable, scary, and is absolutely necessary. There are various therapeutic and psychiatric means of addressing trauma to facilitate freeing ourselves from past experiences and to begin embracing the possibilities life has to offer. If you discover you aren’t free to engage in healthy interactions with people because of your past, consider contacting a professional to help you confront those fears and get your life back!
    Don’t change your game to match a bad experience, change the experience!
Golf
(c) Nathan D. Croy, 2018

An Open Letter to Kansas BSRB

“As long as he denies his own agency, real change is unlikely because his attention will be directed toward changing his environment rather than himself.” 
― Irvin D. Yalom, The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients
Dear Board Members, 
     The Behavioral Sciences Regulatory Board (BSRB) for marriage and family therapists in Kansas has failed to legislate concrete regulations regarding telehealth/telemedicine. At this time, your unofficial stance is to defer to the regulations set forward by HIPAA. While these regulations are helpful guidelines, there are certain factors which impact MFT’s differently than other providers. Telehealth is not only here to stay, research suggests it will only grow larger in the coming years. It is estimated 7 million patients will use telehealth by 2018; this is up from 350k in 2013. Forty-two states have passed legislation regarding the use of telehealth. Twenty-nine states have passed laws requiring health plans to cover telehealth services. Telehealth is NOT going away. The “wait and see” approach is having direct impacts on therapist malpractice risk, income, and patient care.
     The reluctance of the BSRB to pass statutes guiding therapists on appropriate implementation, training, and understanding of telehealth will directly impact our ability to ethically and legally treat patients. Without regulations requiring HIPAA compliant telehealth services, therapists are open to lawsuits and accidental breaches of patient confidentiality. Without these regulations, MFT’s are not restricted to operating within the state(s) where they are licensed, which puts an undue burden on other states and therapists to complete due diligence. Without these regulations, there is no baseline by which all MFT’s can be held accountable, and this puts practitioners at risk for inadvertent malpractice. If there are no regulations regarding additional malpractice coverage to address the practice of telehealth, most providers will be unaware this should be purchased. 
     In 2015, the Board noted that Kansas was “not interested in being part of the “telepsychology compact”.” This was supposed to be discussed in the next meeting, as it was clear nearly 3 years ago that the ubiquity of internet access and technology would make telehealth a meaningful option for more people than ever before. However, no legislation has been created or, as near as I can tell, suggested. This can impact MFT’s ability to bill insurance companies. The Department for Health and Human Services Centers for Medicaid and Medicare Services (CMS) has outlined the requirements to bill for telehealth services. It is feasible that, without consistent definitions of terms, an MFT could bill for what the MFT considers telehealth, while it may not meet the criteria for CMS. There is an additional hindrance to patients covered by KanCare. KanCare has addressed telehealth, but our governing body has failed to do this. 
     The lack of these regulations will directly impact patient care. I have had a patient contact me and request I provide family therapy via telehealth for themselves and a family member living in another state. I declined as I was not licensed in the other state and they did not provide reciprocity. This patient contacted me after finding a therapist who would help and expressed frustration and anger at the incongruence within the profession. Patients entering college may travel out of state but not change residency; where do we stand on providing therapeutic support when there is no reciprocity offered by the other state? What about military personnel living overseas with the ability to participate in family therapy while deployed? 
     While regulations would not ensure complete congruence throughout all MFT practitioners, it will provide those who are compliant a reference source for patients. This is a critical step in maintaining cohesiveness within our profession and our ability to educate patients on our ethical requirements. 
     My suggestion is to create requirements which meet these criteria:
  1. Meet HIPAA guideline
  2. Establish specific criteria for HIPAA compliant software without making specific recommendations
  3. Require a telehealth component to our required ethics training
  4. Suggested malpractice coverage rates
  5. Requirement regarding participation in telehealth/text/phone therapy as it relates to participating in commercial providers (i.e. Talkspace)
  6. Clear regulations for providing telehealth therapy across state lines; particularly in regards to patients in college and the military
  7. Clear regulations on providing telehealth therapy for therapists living outside Kansas; will we offer case specific licensure at a reduced rate?
While there will be many cases not completely covered by your regulations, we must have a starting point. I urge the Board to begin addressing these issues in the next meeting. Please take steps to decrease our professional risk, increase our ethical practice, and protect our patients. We can no longer expect our environment to change. In our profession, we must be congruent and ask of ourselves the same thing we ask of our patients: To embrace our agency and begin changing what we can without externalizing our responsibility.

   Therapists, if you agree it is imperative the BSRB craft and implement regulations regarding MFT’s providing telehealth, please contact the board.

Sincerely,

Nathan D. Croy, MA, LCMFT

HIPAA HELP!
Nathan D. Croy, (C) 2017