#evidence-based therapies | Explore Tumblr Posts and Blogs

butts-bouncing-on-the-beltway · 2 years

Text

I was talking to a client today about "how to identify masking" as part of the process of learning how to shift masking from a reflexive coping strategy to a voluntary and conscious one and I feel like it led to a really important shift in framework FOR ME about masking and social distress.

Paraphrasing, the ideas we came to are as follows:

One of the reasons masking can be so difficult to recognize is because, essentially, masking is the act of performing "yourself" as a mirror for the other person you are interacting with. It's this idea of "I will micro-manage my own mood, affect, behavior, mannerisms, and environment in order to reflect back to you whatever version of "self" you need from me because if I don't there will be consequences". So because masking is essentially performing "mirroring" as selfhood by amplifying or minimizing aspects of yourself based on what you think the other person wants to see in you, it varies significantly from one context to another. The major commonality is that it takes up an INCREDIBLE amount of energy, mental and emotional resources, cognitive processing power, etc. So you don't identify masking by specific behaviors so much as by the feeling of "having a significant amount of your mental/emotional resources be occupied by the act of social interaction" to the point that it doesn't leave enough left-over for other cognitive tasks, or leaves you feeling exhausted and worn out, or basically by the impact that masking has on you during and after.

In this framework, part of why we get so anxious about new or unfamiliar people or situations is because we don't know how to mask in that context yet, and so until we get there and figure it out, we're basically just terrified of what could go wrong since we don't know what we're walking into.*

*This is the underlying framework of anticipatory and obsessive anxiety as well. Anticipatory and obsessive anxiety functions as the mechanism by which we conduct both predictive reasoning-basd advance planning and review/self-correctionof our mental predictive model.

Autistic aversion to uncertainty has a lot to do with our need to be able to use predictive reasoning-based advance planning to cope with "social deficits" aka how much harder it is for us to interpret subtextual/nonverbal cues, learn/meet social expectations, and work through/around disordered sensory processing. That predictive reasoning requires us to be familiar, in advance, with the stable constant factors that influence decision making in social contexts. If we aren't familiar with the constant variables than we can't plan, if we can't plan than we are more likely to make noticeable social mis-steps, and if we take notable social mis-steps there are consequences. It becomes necessary for us to be hypervigilent to observable patterns in other people's behavior in order to try to reverse engineer the social interaction playbook on the fly. That ends up making us more likely to assume personal responsibility for predicting and managing the emotional regulatory needs of people around us at all costs, replicating the behavioral/cognitive impacts of chronic traumatic stress due to the activation of our sympathetic nervous system from chronic hypervigilence.

Essentially, masking is a cognitive defense mechanism to severe and/or persistant traumatic interpersonal stressors. As the neurological impacts of chronic traumatic stress heal, we mask less frequently. But in order to heal from chronic traumatic stress, the human brain requires a safe environment that does not trigger a retraumatization episode or replicate feelings of helplessness/fear for safety. In other words, reducing/terminating masking safely requires us as autistic people to have consistent access to social environments in which we are able to utilize autistic interpersonal boundaries without fear of consequence or chonically unmet need. This requires the people around us to be able to respect not only autistic interpersonal boundaries, but also autistic self-expression/advocacy modalities and mediums.

I feel like a lot of the pieces of this framework have been rattling around in my head for a while but the flavor of words hit just right today and all the connections snapped into place.

Anyway, I'm still sort of sorting through the clinical implications of this framework but I think it's a direction I want to keep exploring for sure.

#i love my ASD client sessions it's so fucking MAGICAL how much those clients are thriving as we work together #like I don't know how to describe how well therapy goes when the client and clincian are speaking the same language it's really cool #anyway I feel like this is going to be part of how I assert the validity of my new modality because hot damn does it sync up perfectly #this framework so perfectly outlines the logical justification for the modality's clinical foundations #which will be really helpful in asserting the extant body of literature/evidence base for those clinical foundations as relevant #i need to update the files for my thesiiiiiiiiiiiiiis #actuallyautistic

2K notes · View notes

religion-is-a-mental-illness · 1 year

Text

By: SEGM

Published: Apr 18, 2023

The field of gender medicine must stop relying on social justice arguments and return to the time-honored principles of evidence-based medicine.

A new article in Springer’s Current Sexual Health Reports, “Current Concerns About Gender-Affirming Therapy in Adolescents,” provides an up-to-date overview of the current state of evidence about the practice of gender transition in youth in the Western world and discusses the international debates surrounding this controversial practice.

The authors identify the key area of concern: It is unknown how gender-transitioned young patients fare in the long term. Systematic reviews of evidence of youth gender transition are naturally limited by short follow-up times, as the practice only began at scale after 2015. For this reason, it is informative to look at long-term adult outcome data. Unfortunately, the long-term studies of adult transitioners have repeatedly failed to show lasting psychological improvements, and studies with the longest follow-up suggest "the possibility of treatment-associated harms."

In fact, the disappointing long-term outcomes of adult transitioners were used to justify transitioning minors, in the hope that earlier intervention would lead to improved outcomes. However, every quality systematic review of youth gender transition to date has failed to find credible benefits even in the short-term, issuing conclusions about the risk-benefit ratio that range from highly uncertain to unfavorable.

The authors observe:

There has never been a dispute about whether medical and surgical interventions can feminize or masculinize secondary and some primary sex characteristics. For children and adolescents, the debate is not whether such transformations are possible, but “at what age can youth meaningfully consent,” “upon fulfilling which criteria,” and perhaps most importantly, “just because we can – should we?”. Such questions have provoked an intensity of divisiveness within and outside of medicine rarely seen with other clinical uncertainties. This passion reflects decidedly different prioritization of scientific evidence, medical ethics, and social values.

Ten key unproven—or disproven—assumptions underlying the practice of youth transitions

The authors note that while a “growing number of European countries recognized deficiencies in the evidence supporting the highly medicalized “gender-affirming” approach to treating gender-dysphoric youth, in North America, the narrative that “gender-affirmative care has been scientifically proven” has been remarkably resilient.”

The authors observe that the practice of “gender affirmation” of minors using hormones and surgery is based on 10 key fallacious assumptions that are misrepresented as proven facts:

The emergence of a trans identity is the result of reaching a higher level of self-awareness.

Whether the trans-identity emerges in very young children, older children, teens, or mature adults, it is authentic and will be lifelong.

All gender identity variations are biologically determined and inherently healthy.

The frequently co-occurring psychiatric symptoms are a direct result of gender incongruence (the so-called “minority stress” model).

The only way to relieve, or prevent, psychiatric problems is to alter the body at the earliest signs of puberty.

Psychological evaluations and attempts to address psychiatric comorbidities should only be used to support transition.

Attempts to resolve gender dysphoria with psychotherapy range from ineffective to harmful.

Gender-dysphoric youth must have unquestioning social, hormonal, and surgical support for their current gender identities and desired physical appearance.

All individual embodiment goals, even those that do not occur in nature, must be fulfilled to the full extent technically possible.

Science has proven the benefits of early gender transition, and low rates of regret and detransition further validate the practice.

The authors refute these assumptions, focusing on the three most critical fallacies. They recount the evidence that identity formation in adolescence is far from complete, and a trans identity for many will prove to be temporary. They note that the rationale for “gender-affirming” interventions has shifted from reducing extreme suffering, to merely fulfilling individual embodiment goals, which undermines the original premise of administering drastic, irreversible interventions off-label to young people whose identities are far from fully formed.

Finally, the authors note that the claim that gender-transition is a proven net-beneficial practice is demonstrably false. The claims by gender medicine clinicians that these interventions are “proven” collapse when scrutinized through the lens of systematic reviews, which are a fundamental requirement of evidence-based medicine. Unlike “narrative reviews” which the field has come to rely on, and which cherry-pick “favorite” studies and merely restate those studies' biased conclusions, systematic reviews require the analysis of all the available evidence, subjecting each study to a critical appraisal for risk of bias and other methodological problems, issuing an overarching conclusion which states the effects of a given treatment, and grades evidence for quality/certainty.

To date, every systematic review of evidence has concluded that the evidence of benefits is highly uncertain. The only disagreement is about the harms: some consider the harms also uncertain, while others note that the evidence of potential harms to bone and cardiovascular health, and the expected infertility and sterility, render the practice net-harmful for most youth today.

Clash of Ethical Principles and Value Systems

The authors note that most clinicians involved in the heated debate over gender-transitions of youth believe that they are practicing according to the principles of medical ethics. The disagreement comes from a clash in value systems:

Those who insist that a young person has the right to receive any medical intervention they desire now, and the right to regret that intervention later, privilege autonomy above all else. Those who advocate for sharply curbing the practice of medical interventions in gender-diverse minors because they view the practice as a major source of iatrogenic harm, privilege the principle of non-maleficence.

They also acknowledge that there is disagreement about what constitutes beneficence:

Each side claims they are pursuing beneficence, but sharply disagree on the solution: one side insists that the most benefit is derived by undergoing a transition as early in puberty as possible to achieve the best possible cosmetic outcomes, while the other asserts that achieving cognitive maturity, emotional stability, and obtaining life experiences (including sexual experiences) prior to making the decision to undergo irreversible transition will provide the most long-term benefit for affected individuals.

Detransition and Regret

The authors point out the growing evidence of significant rates of medical detransition, which has reached 30% in at least one comprehensive analysis of US data. They note that while not all detransition signifies regret, the claims of less than 1% regret rates are not credible.

Most studies reporting low regret rates define regret narrowly, such as requesting a legal change of sex markers or beginning the administration of natal-sex hormones. However, many detransitioners do not have their gonads (ovaries and testes) removed, so they have no need to supplement with natal sex hormones upon detransition. One of the most-frequently quoted studies of “very low regret” would not have considered Keira Bell, one of the best known regretters whose case contributed to the UK’s current restructuring of its approach to managing gender dysphoria in youth, to be a regretter.

The authors acknowledge that regret is a complex phenomenon, and regret and acceptance can co-exist. For many people who have undergone the most extensive physical changes, detransition is not possible, and many choose an adaptive approach of making the best of their lives without undergoing more invasive procedures. However, as the numbers of detransitioners grow, regret and lawsuits by harmed patients will likely increase in number and visibility.

The Reversal of “Gender-Affirming Care”

The authors note that public health authorities are increasingly aware that hormones and surgery are being administered to a growing number of children and adolescents with gender dysphoria who are unlike previous cohorts of transgender-identifying individuals. In years past, the majority of youth seeking to transition were male and had longstanding gender dysphoria. Today, the preponderance of young people with gender dysphoria are females whose transgender identities emerged only in adolescence and who suffer from pre-existing mental illness and neurocognitive disorders.

After public health authorities in England, Finland, and Sweden conducted systematic reviews of the available evidence to determine whether the benefits of youth gender transition outweigh the risks, they concluded that the benefits do not outweigh the risks and have revised their practices and policies, sharply restricting medical and surgical transition of children and adolescents. Reassessment of policies governing gender transition of youth also is underway in France, Norway, and several US states.

In the United States, a number of states have begun to pass laws that sharply restrict the availability of "gender-affirming" interventions in general medical settings. The authors suggest that politicization of this complex issue may have been a direct result of the US medical societies' decision to privilege civil rights arguments over the principles of evidence-based medicine:

Many US state laws have been introduced to limit or ban gender transitions of youth. The reluctance of the US medical societies to recognize the apparent problems with medical “gender affirmation” of youth may have contributed to the unfortunate and preventable politicization of this complex issue.

The authors remind clinicians that while social justice, civil rights, and freedom of expression are compelling arguments, they complicate “clinicians’ consideration of how to respond to gender dysphoric adolescents and their families." The authors note that concerned family members want to know: " 'Where is this identity coming from?' 'What about my child’s previous difficulties?' and critically, 'Will transition give my child the best chance for a happy and fulfilling life?' "

When faced with such questions, "clinicians are ethically bound to honestly represent the uncertainty of the current state of knowledge, rather than asserting that body modification is the best, safest, and most effective treatment. When a concerned family seeks our counsel, they are seeking our knowledge, not our political ideation and beliefs.”

#SEGM #Society for Evidence Based Gender Medicine #medical transition #queer theory #genderwang #gender ideology #trans identity #gender identity #sex trait modification #gender pseudoscience #medical malpractice #medical scandal #gender affirmation #gender affirming #affirmative therapy #affirmation model #detransition #detrans #religion is a mental illness

18 notes · View notes

coochiequeens · 6 months

Text

In concluding their piece, Lahl and Fell said: 'The authors' suggestion that medical providers should deviate from the principle of 'do no harm' to follow paths where the evidence indicates harm is quite shocking.""This perspective, driven more by ideology, emotions, and personal desires than by evidence, conflicts with the foundations of evidence-based medicine.'

MSU sociology professor Dr. Carla Pfeffer is slammed over scientific journal article saying trans men should be allowed to take testosterone while pregnant, despite warnings hormones may trigger severe health issues in fetuses

Dr. Carla Pfeffer published a paper alongside five other academics concerning the use of testosterone therapy during transgender pregnancy

The sociology professor and her cohorts have since been slammed by two nurses for disregarding the safety of a fetus 'in the name of trans inclusion'

Jennifer Lahl and Kallie Fell hit back at the study, deeming one portion of it 'quite frankly, insane'

By JOE HUTCHISON FOR DAILYMAIL.COM

PUBLISHED: 10:37 EDT, 20 October 2023

A professor has been slammed over a scientific journal in which she said trans man should be allowed to take testosterone while pregnant, despite warnings it could trigger severe health issues.

Dr. Carla Pfeffer, who is not a medical doctor, penned a new paper alongside five other academics titled 'Medical uncertainty and reproduction of the 'normal': Decision-making around testosterone therapy in transgender pregnancy.

Pfeffer, who is a sociology professor at Michigan State University, argues that pregnancy care is too focused on helping women have healthy babies, and that trans men might be fine to take testosterone while pregnant.

The authors , who are sociologists, have since been accused of choosing to disregard the safety of a developing fetus 'in the name of trans inclusion'.

In a scathing response to the paper, two nurses have criticized the article saying if abiding by their take 'would land us in a vacuum devoid of medical ethics'.

Dr Carla Pfeffer, pictured here, published a paper alongside five other academics concerning the use of testosterone therapy during transgender pregnancy

The sociology professor and her cohorts have since been slammed by two nurses for disregarding the safety of a fetus 'in the name of trans inclusion'

Authors Jennifer Lahl and Kallie Fell, who is the Executive Director at The Center for Bioethics and Culture, published a response to the paper titled: 'Is There a Doctor in the House?'

In it, they said: 'The authors argue that 'gendered' pregnancy care is too focused on helping women have healthy babies, and that it might be okay for transmen to continue taking testosterone during pregnancy despite the known health risks to the fetus and effects on its normal development.

'This is, quite frankly, insane.'

In the paper, Pfeffer and her fellow colleagues had studied 70 international trans individuals and 22 health care providers who focus on trans people.

Their paper says: 'We argue that in the context of lacking and uncertain medical evidence (HRT with testosterone during pregnancy and chest feeding) in a highly gendered treatment context (pregnancy and lactation care), both patients and providers tend to pursue precautionary, offspring-focused treatment approaches.'

In response, Lahl and Fell say the findings are flawed as only biologically fertile human females possess the attributes for pregnancy and childbirth.

The two label this 'a simple biological reality', saying that pregnancy care isn't 'gendered' at all.

According to the Mayo Clinic, testosterone may cause birth defects if a pregnant woman comes into contact with it.

Lahl and Fell also added: 'The concerns raised by Pfeffer and colleagues focus on the modern treatment approach physicians take, which they deem excessively 'precautionary' and 'offspring-focused.'

Kal Fell, front, and Jennifer Lahl, background, published a response to the paper titled: 'Is There a Doctor in the House?'

'Fortunately, caring for the child and the mother are neither mutually exclusive nor zero-sum.

'In situations where a woman aspires to become pregnant and commits to motherhood, physicians can provide care that optimizes outcomes for both parties while minimizing potential harm.

'If a woman chooses to continue a pregnancy, doesn't the developing fetus also have a right to the four principles of medical ethics?'

'In such cases, the physician is duty-bound to care for both the child and the mother.'

One health care provider also told researchers: 'I think if you choose to have a pregnancy and your female hormone levels would be already so high that testosterone probably wouldn't even mentally help.

'If you're producing breast milk and you couldn't be without testosterone for mental health, if you couldn't deal without testosterone, then you probably shouldn't be pregnant.'

'This perspective, driven more by ideology, emotions, and personal desires than by evidence, conflicts with the foundations of evidence-based medicine.'

#Dr Carla Pfeffer is a sociology professor #Why is she writing papers on maternal and fetal health?#Jennifer Lahl is speaking the truth #Kallie Fell is speaking the truth #Medical uncertainty and reproduction of the 'normal': Decision-making around testosterone therapy in transgender pregnancy #michigan state university #Pregnancy care is too focused on helping women have healthy babies #statement showing transcult brain rot #The transcult and medical ethics #disregard the safety of a developing fetus in the name of trans inclusion'#Is there a Doctor in the house?#Pregnancy care isn't gendered it's sex based #evidence based medicine

4 notes · View notes

goldlightsaber · 1 year

Note

The comments about Olivia Wilde are disgusting. And no one is pushing back on it. I could not belive how bad it was when I saw the replys to that tweet. I mean they act like she fuckin killed people! it's truly insane how women are treated. And you're absolutely right about Brad Pitt and how men are treated in comparison. It makes me so angry

Yeah it makes me angry too. Like, a woman has one public slip-up and suddenly they’re a “snake” “evil” “opportunist” — someone said “oh look she’s smirking because she’s having her moment spotlight with Pedro” what the fuck. Like implying that she, who had already made a name for herself before he even got famous, was posing with him for fame…that’s so crazy. They were just standing next to each other at at event they were both invited to. Makes you realize just how wildly the idea of a gold digger, opportunist woman permeates society.

#idk how Olivia is coping with it tbh. I would be going to therapy twice a week and crying constantly if I saw comments like that #this happened with Amber heard too #like that’s a tricky one and different but #like regardless of what she did the the misogynists vitriol against her was vile #meanwhile Johnny d*pp is hailed as a hero #even tho a court ruled based on evidence that he very much was not #ppl have opinions like they were THERE #when in reality they’re just projecting their sexist assumptions onto the person #ask #anonymous

7 notes · View notes

vanilla-voyeur · 9 months

Text

Not to be all 2012 r/atheism but it is kinda frustrating how hard it is to get people to understand that I don't believe in ANYTHING spiritual or supernatural. Like I say I'm an atheist and people think that just means I think church is homophobic but also still totally believe in god and heaven and souls and w/e. (I actually would like to go to a UU church if I still had the ability to regularly wake up on a Sunday morning.) So then I try secular humanist, and they still don't get it. Like the more I try to explain in a way that might get through to people, the more I start sounding like the most annoying condescending things Richard Dawkins and Sam Harris have said.

I have dealt with multiple therapy groups that say they do "holistic" therapy and list stuff like art therapy and music therapy. But then it turns out they also do acupressure and ashwagandha and qi. This latest one was so annoying because I said I was a secular humanist, I don't believe in anything spiritual, I only believe in science, I specifically listed some of the alternative "medicine" stuff that's been pushed on me in the past that I don't want. And then the lady assured me that oh dw by holistic they just mean art therapy and music therapy. It was only after she told me they were affiliated with one of the worst, most toxic, most unscientific groups I've had the displeasure of dealing with, that I pushed for more clarity and she admitted that they would use reiki in meditation. (Meditation is evidence-based, reiki is not.) Like the fact that she didn't realize they could be done separately was just *sigh*

Like why not just be up front? Why not just say "we do holistic therapy, such as acupressure, reiki, and natural herbs"? Why pretend that all you got going is art and music and yoga? Are you trying to trick me into practicing your bullshit?

My religion is science. Please respect my religious beliefs and don't try to force yours on me.

#secular humanism 🤮#I believe in science 🤮#My religion is science 🤮#I have fully given up on accurately describing my beliefs #please tell me what sort of fairytales I need to spin so you can stop forcing bs on me #If I have to deal with one more asshole proselytizing woo I will start unironically using the term sky daddy #Like I ideally would be respectful of other peoples beliefs but respect goes both ways bro #Would skeptic work? I havent tried skeptic before #Tbh my biggest problem with the affiliate group was not that they were wasting my time teaching me ways to tap my wrists #But actually because they were misusing evidence based therapies like DBT to literally bully clients they didnt like #Bruh Check the Facts does not mean you get everyone in the room to say in unison that one clients beliefs are not factual #I know most therapists who say they do a dozen different therapies including DBT are incredibly uninformed about what DBT really is #But that was just next level yikes

2 notes · View notes

synergysobrietysolutions · 2 months

Text

Addiction Recovery Programs

The Benefits Of Choosing Our Palm Beach Drug Treatment Center For Recovery

Deciding on the perfect drug treatment center can seem like a daunting task. We know because we’ve walked down that road, making those difficult decisions alongside many like you.

In this article, we want to highlight why our Palm Beach Drug Treatment Center is more than just a place of healing—it’s where your journey to recovery and strength begins. With countless success stories and comprehensive treatment programs under our belt, let us be your guiding light toward a brighter future.

Let’s take that first step together in Palm Beach County towards a healthier life starting right now. Contact Synergy Sobriety Solutions today for addiction treatment, and we will assist you in recovery!

Key Takeaways

Our Palm Beach Drug Treatment Center has years of experience in helping people overcome drug and alcohol addiction with unique, effective treatments.

We offer personalized care through gender and age-specific programs, tailored treatment plans, and a skilled multidisciplinary team to address each individual’s needs.

Our center provides a luxurious environment with amenities like private rooms, gourmet meals, and fitness centers to promote a comfortable recovery process.

We guarantee long-term support with continuous aftercare options, including group therapy sessions, one-on-one counseling, and workshops to maintain sobriety after treatment ends.

Most insurance plans cover our services, making high-quality rehab accessible without the financial burden.

Our Palm Beach Drug Treatment Center for Recovery

Our Palm Beach Drug Treatment Center stands out, with years of helping people win their fights against addiction. We offer unique treatment programs that cater to each individual and are backed by experts who know how to guide you through recovery.

Years of Experience

We’ve spent years helping people recover from drug and alcohol addiction. This long history means we know what works best in addiction treatment. We’ve seen trends come and go, but our commitment to providing effective, evidence-based therapies has remained constant.

Our experience guides us in offering the most successful recovery paths for those struggling with a substance use disorder. Next, we tailor our programs to meet specific needs—whether it’s gender-specific support or age-related concerns.

Gender and age-specific programs

Building on our four decades of experience, we understand that effective treatment isn’t one-size-fits-all. Our gender and age-specific programs are tailored to meet the unique needs of each individual.

This approach ensures a more comfortable and supportive environment for everyone involved. Men, women, teenagers, and older adults can find spaces where they feel understood and safe. These settings allow for targeted therapy that addresses the distinct challenges faced by different groups.

Our team knows how important it is to consider all aspects of an individual’s identity during recovery. By separating groups based on gender and age, we create opportunities for patients to share experiences with peers who relate closely to their situation.

This fosters a sense of community and belonging, which is critical in overcoming substance abuse. Each program is designed with specific recovery goals in mind, considering the psychological differences and societal pressures unique to each group.

Skilled multidisciplinary team

Our team is a mix of experts from different fields. We have doctors, nurses, psychologists, and therapists all working together. They’re focused on providing the best form of treatment for drug and alcohol addiction.

Each member brings their unique skills to help with mental health disorders, substance abuse and addiction treatment, and ensuring long-term recovery.

They create personalized treatment plans for each patient. This means looking at every aspect of a person’s health—mental, physical, and emotional. Our staff uses evidence-based therapies like individual, family, and group therapy to support recovery. With such a wide range of expertise, we tackle addiction from all sides.

Various substance abuse treatment modalities

Building on our team’s diverse expertise, we offer various treatment modalities to meet individual needs, from inpatient programs for deep, intensive treatment to partial hospitalization and an intensive outpatient program (IOP)for those balancing recovery with daily life.

We embrace evidence-based therapies like cognitive-behavioral therapy and innovative approaches like equine therapy. This ensures every aspect of addiction—physical, mental, and emotional—is addressed.

Holistic methods play a crucial role, too; they complement traditional treatments by focusing on overall well-being. Exercise, nutrition advice, and stress management techniques are integral to our approach.

We emphasize personalized care that adapts over time for long-term sobriety and healthy living beyond the rehab facility. Each person walks a unique path to recovery—we’re here to guide you at every step with the right combination of treatments tailored just for you.

Benefits of Choosing Our Palm Beach Drug Treatment Center

Our Palm Beach Drug Treatment Center offers unmatched support for your journey toward sobriety, providing a blend of luxury, personalized care, and proven strategies to ensure you recover and thrive. Discover more about how we can transform your path to recovery.

Luxury amenities and environment

We provide an upscale setting that enhances comfort during the recovery journey. Our patients enjoy luxurious amenities like private rooms, gourmet meals, and serene outdoor spaces. These features create a stress-free environment crucial for focusing on addiction recovery.

Our West Palm Beach drug treatment center boasts beautiful surroundings, promoting physical and mental well-being. Facilities include fitness centers and therapeutic recreational areas—essential for holistic healing. This inviting atmosphere supports long-term sobriety by making the alcohol rehab experience as positive as possible.

Personalized addiction treatment plans

Our Palm Beach addiction treatment center believes every individual’s journey to recovery is unique. We offer personalized treatment plans tailored to each person’s needs and circumstances. Our skilled team works closely with clients, considering their history of substance abuse, personal challenges, and goals for the future. This approach ensures everyone receives the most effective care designed just for them.

From our full treatment centers to partial hospitalization and intensive outpatient programs, we adapt our services to fit your life stage and responsibilities. Whether battling addiction to alcohol, prescription drugs, or other substances, our comprehensive plans leverage evidence-based therapies aimed at long-term sobriety.

During this transformative process, holistic recovery programs also support physical and mental health and well-being. With us, individuals seeking treatment find a path explicitly crafted for them–one that leads to a healthy life free from addiction.

Continued support and aftercare

We understand recovery doesn’t end after completing treatment. We offer continued support and aftercare programs, providing the tools you need for long-term sobriety.

These include access to group therapy sessions, one-on-one counseling, and workshops on managing triggers and stress. We aim to stand with you every step of the way, ensuring a seamless transition back into daily life while maintaining your well-being.

Our team keeps in touch regularly, offering advice and encouragement even after you return home. We connect you with local support groups and ongoing outpatient treatment options to keep your recovery on track.

This holistic approach helps prevent relapse by surrounding you with a supportive community focused on sustainable recovery—preparing you for the challenges ahead without feeling overwhelmed. Next, let’s dive into how being accepted by most insurance plans makes accessing our quality care easier for many individuals seeking help.

Accepted by most insurance

Most insurance companies see the value in our Palm Beach drug treatment program and center for recovery. They cover a wide range of services we offer, from alcohol rehab to residential treatment.

This means less worry about costs and more focus on getting better. Our team works directly with your insurance company provider to ensure you get the maximum benefits for your treatment plan.

Conclusion

Our Palm Beach Drug Treatment Center offers a unique blend of experienced care, tailored outpatient programs, and luxury comfort. With years in the field, we understand the journey to recovery—inside out.

Our approach ensures long-term sobriety through personalized treatment plans and ongoing support. Plus, being accepted by most insurance makes quality rehab accessible for many. Choosing us means opting for a path marked by individualized care, a holistic approach to healing, and an unwavering commitment to your well-being.

If you or someone you know struggles with an addiction, help is available at Synergy Sobriety Solutions in Palm Beach, Florida. We offer professional drug and alcohol treatment services tailored to your needs. Call us at 561-562-9715 or Contact us today for more information on how we can assist you toward recovery and conquering your substance use disorders!

0 notes

ramyeongif · 9 months

Photo

deeply in love with this

#lucy dot jpg #evidence based practice #psychology #therapy #58753

2 notes · View notes

wolvierinez · 10 months

Text

i have very complex thoughts about logan just as a character that i can't really articulate right now but he's just inherently. and he tries to not be. but it's just a reflex for him at this point to. and he.

#could i elaborate. maybe. ill have to read more of his comics to actually gather evidence #as the logan i made up in my mind. while based on comics. isnt 100% comic accurate #and its been a while.#hes just been through a lot him acting like that is a result of everything hes been put through #that doesnt make it healthy. its not. but i think he knows that and does eventually want to get better.#but hes kind of like. trapped in a cycle.#something something MARVEL LET HIM RETIRE FOR A WHILE #have it be like the time he died onky he isnt dead hes having a break.#he can come back ! he just needs time off to like get therapy or something.

6 notes · View notes

monstermoviedean · 2 years

Text

there has to be some kind of middle ground between "academia is built on oppression and gatekeeping and privileges elite white knowledge and therefore cannot be trusted" and "academia is the only true source of knowledge." there has to. there has to be something between "any random person can be trusted as an expert" and "no one can be trusted without a doctoral degree."

#i get that there are legitimate problems with academia but sometimes i think we should trust and value the knowledge of people who have #dedicated years or decades to learning as much as possible about a field #i think this is part of my problem with the trainer i've been complaining about #they are a relative of a person affected by suicidality and have a platform based on that lived experience #and i don't want to invalidate that because I think sometimes lived experience can be more relevant and helpful than academic knowledge #but it depends!#talking about evidence based practices and 'practices that have evidence' as if they are equally valid makes me uncomfortable #and i thought i was just being elitist but now i'm not sure #sure if someone wants to use crystals to treat their suicidality let's try it but please don't act like that's equally valid to therapy #i think that's my overall issue with them. that everything is presented as equally valid.#making suicide memes could help someone cope but that doesn't mean it's a valid suicide prevention strategy.#crystals may placebo-effect someone into feeling better and that's awesome but they should also get professional help.

9 notes · View notes

harrowharkwife · 1 year

Text

#god i need to go back to therapy but i don't want to unless i can find a therapist #who is experienced in working with autistic adults #i just. ive accepted at this point that om not going to get anywhere #or get anything helpful #out of therapy until/unless i start acknowledging my autism in the process instead of trying to continue pretending it's not there #like. talk therapy just isn't going to be useful for me otherwise. I've hit the ceiling in terms of what progress i can make #without turning over that log #and i just. i really WANT therapy for my autism. not in a 'fix me' sense bc there's nothing wrong with me #i love my autism #but. it's getting to be really god damn fucking painful and embarrassing and heartbreaking feeling like i can't have a fucking conversation #i just. i want to work on my social skills. they didn't use to be this bad idk what happened! the pandemic probably tbh but ugh #i just. never know what to say or how to say it and it feels like im constantly fumbling and im never paying enough attention #to the other person bc im too busy just trying to fucking listen to them and process what they're saying and figure out what to say back #and i just get so nervous about communicating correctly that what comes out of my mouth doesn't match my thoughts at all #i barely even know what i'm saying half the time and that's. terrifying #but it's just so hard finding a therapist already let alone finding one whos a) experienced in evidence based and compassionate autism care #and b) normal and not an ableist freak about it

2 notes · View notes

religion-is-a-mental-illness · 1 year

Link

By: Society for Evidence Based Gender Medicine

Published: Dec 9, 2022

To what extent are the purported short-term psychological benefits of “gender-affirming” care, reported by some recent studies conducted by pediatric gender clinics, due to the placebo effect, rather than the hormonal and surgical interventions themselves? This question is the focus of a new tour-de-force peer-reviewed publication in the Archives of Sexual Behavior by Dr. Alison Clayton.

Clayton, a researcher and practicing psychiatrist (who is also affiliated with SEGM), has been a powerful, sober voice in the increasingly heated debates in gender medicine. During the past 24 months, she alerted readers to the “marked asymmetry in outcomes reporting” by gender clinics, where the “findings of positive outcomes of medical interventions are trumpeted in abstracts, while their profound limitations remain behind the paywall, thus, below the radar of busy clinicians.” She was one of the first clinicians to point out that "gender-affirming" practices fall, at best, in the “innovative clinical model” and are not ready for wide-scale use in general medical settings. Her ongoing research into misadventures in medicine that had harmed vulnerable patients—such as prefrontal lobotomy for mentally ill patients—informed Clayton’s concerns about troubling parallels between those eschewed practices of the past, and the currently-celebrated practice of offering mastectomies to gender-distressed female minors.

In her most recent article, Clayton argues that the findings of modest “benefits” of hormonal and surgical “affirming” interventions are compromised by the placebo effect—the expectation of benefits heavily promoted by enthusiastic providers, and indeed the entire cultural narrative. Clayton poses the next logical question: If the placebo effect is not only in play but is also likely responsible for the reported short-term benefits, is that a problem—as long as the patient gets better? Clayton’s overview of the significant health risks of euphemistically-termed “gender-affirming” interventions is a powerful reminder of why, while the “placebo effect” is a welcome addition to the plethora of ways in which medical treatment may help patients, it should only be called upon when the treatment itself has proven net-beneficial in a controlled trial—something that has never occurred in pediatric gender medicine.

Short-term benefits from placebo effects are common and may even endure, depending on the condition (e.g., they may aid in treatment of heart disease and depression, but do not shrink tumors). However, the price that young gender dysphoric patients will pay for the benefits of the “placebo” effects is unacceptably high, as it involves infertility, sexual side effects, and a growing list of medical health risks—along with the certainty of lifelong medical patienthood and the risk of regret over irreversible interventions. Currently, as many as 30% of individuals (19% of natal males and 36% of natal females) who initiate "gender-affirming" interventions, stop them 4 years later; however the harmful effects of these interventions are often life-long.

Clayton asserts that "gender-affirming" interventions for youth constitute a perfect storm for placebo effects and observes that current research is unable to distinguish benefits resulting from placebo effects from those of specific treatments. Clayton’s in-depth, nuanced analysis and discussion of these issues cannot be reduced to a short summary, and we encourage readers to set aside the time to read the original publication in its entirety. However, we briefly summarize the key points, well-aware that we cannot do justice to the remarkable scholarship of this publication:

What are placebo effects? Placebo effects are the beneficial effects (and nocebo effects are deleterious effects) attributable to the mind-body response evoked by treatment context rather than those caused by the specific action of the treatment. Placebo effects can lead to real, measurable improvement in a patient’s clinical condition.

How are placebo effects distinguished from specific treatment effects? Typically, prior to their introduction into routine practice, new medical treatments are subject to rigorous research. The double-blind randomized controlled trial is the gold-standard for distinguishing a treatment’s specific efficacy from placebo effects. There have been no randomized controlled trials undertaken of the various "gender-affirming treatments" that are presently routinely provided for gender-dysphoric youth. Other clinical research methods that do not rely on the use of inert “placebos” are also capable of distinguishing and mitigating the placebo effect, but such studies have not been undertaken either.

Why is it important to differentiate placebo effects from specific treatment effects in gender medicine? It is vitally important to know whether we are using treatments—especially those carrying significant risk of adverse effects—solely to realize benefits due to placebo effects. First, although some placebos such as sugar pills do not have direct adverse effects, this cannot be said of hormonal and surgical gender-affirming treatments. There are numerous potential adverse risks of gender-affirming treatments, including: impaired fertility, sterility, cardiovascular disease, osteoporosis, cancers, impaired brain development, impaired sexual function, surgical complications including mortality and later regret/detransition. Second, placebo prescribing does not meet modern medicine’s requirements for honesty, medical transparency, and patient autonomy—all of which underpin informed consent. Thus, even prescribing a “harmless” sugar pill to a patient is inconsistent with modern medical ethics and practice. Ultimately, “a medical profession that does little to distinguish placebo effects from specific treatment effects risks becoming little different from pseudoscience and the quackery that dominated medicine in past times, with likely resulting decline in public trust and deterioration in patient outcomes.”

Is it unethical to perform comparative quality research capable of mitigating the placebo effect in pediatric gender medicine? The Dutch researchers, who pioneered the "gender-affirming" hormonal and surgical treatment approach for youth, asserted that such research would have been unethical. However, the ethics of implementing a new treatment without a rigorous evidence base also must be considered. There are many examples of medical practices that have later been shown to be more harmful than beneficial. For example, through much of the latter half of the twentieth century, most pediatricians and medical organizations recommended, based on clinical wisdom and low quality evidence, the prone sleeping position for infants. They claimed the prone position decreased the risk of death from aspiration of vomit. Subsequently, quality epidemiological research revealed prone sleeping as a major risk factor for sudden infant death syndrome (SIDS) and parents were advised to use a supine (back) infant sleep position. Prone sleeping is thought to have contributed to the deaths of tens of thousands of infants. Today, gender-affirming care for gender-dysphoric youth not only lacks any randomized controlled trials but also any high or even moderate-quality prospective observational studies. Thus, there is only very low-quality evidence for the alleged benefits of these interventions in youth. As recent systematic reviews of evidence from the UK demonstrated, the reported mental health benefits, which are the principal rationale offered for implementing these treatments in youth, are likely due to bias, confounding and chance, and placebo effects make a key contribution to the unreliability of these findings.

What makes youth “gender-affirming” medicine a “perfect storm” for placebo effects? Youth gender medicine presents a confluence of other elements that make it a “perfect storm” for placebo effects: It relies on subjective criteria for diagnosis and treatment outcomes. There are no objective diagnostic tests for gender dysphoria and it is assessed largely on the basis of patient self-reports. Placebo effect research has demonstrated that placebo responses are particularly noted in patient-reported symptoms and outcomes–such as anxiety, pain, life satisfaction, mood, and behaviors. The as yet unexplained massive increase in the prevalence of gender-dysphoric youth presenting to clinics and its preponderance of female tweens and teens heightens this concern. Gender clinics exclusively promote gender-affirming interventions. Child and adolescent gender clinics problematically conflate clinical advocacy and research agendas. Most clinics present gender-affirming interventions as very low risk, high-success interventions. In contrast, they often eschew noninvasive alternatives such as psychotherapy as useless at best, and unethical and harmful at worst. This orientation primes patients to experience positive short-term effects of hormones and surgery due to placebo, negative short-term effects of delaying the “affirmative” treatment due to nocebo (negative self-fulfilling prophecy effect), and generally undermines research performed in gender clinic environments. Gender clinics and the media propagate ethically-questionable and inaccurate suicide narratives. Gender clinicians and the media often overstate, exaggerate and even falsify suicide-risk among trans-identified youth. For example, claims are made that if children don’t receive puberty blockers they will commit suicide, despite the fact that there is no evidence that puberty blockers decrease suicide rates. These types of narratives pose a dangerous nocebo effect, which may act to increase suicidality and suicide risk. Societal celebration of the “affirmation” narrative. The celebration of trans rights has been a double-edged sword, both increasing acceptance of gender diversity but also inadvertently signaling to gender dysphoric youth that transition will produce happiness or fulfillment. In part this narrative is fueled by gender clinicians, some of whom are financially motivated and actively promote the interventions on social media popular with minors, such as TikTok. At the same time, balanced coverage that highlights the risks and uncertainties is frequently shut down. This media/social media milieu may foster “emotional contagion,” contributing to the dissemination of gender dysphoria symptoms and behaviors throughout the community, with the placebo effect contributing to the short-term “improvements” due to “gender affirmation.” Strong pro-transition bias in scientific information shared. Gender clinicians, who typically lead research in pediatric gender medicine, tend to overstate claims about the strength of the evidence and certainty of benefit, while discounting the risks of pediatric gender transition. This contrasts with their more cautious statements, often hidden behind paywalls, in the peer-reviewed literature. This presents a two-faced narrative: a placebo-effect-enhancing overstatement of certainty/strong evidence of benefit displayed to gender-dysphoric youth, their families, and policy makers—and the more realistic face of uncertainty and a dearth of evidence that is available only to the most committed students of the medical literature who have the skills and time to critically assess the existing studies.

Is concern about the placebo effect unique to gender medicine? The challenge of distinguishing placebo from treatment effects is not unique to gender medicine. However, they have been surmounted in other areas of pediatric medicine where the risks of treatments are substantial but are supported by higher quality evidence. In addition, in other areas of medicine, the placebo effect is often discussed and acknowledged (e.g., the role of placebo effect in response to antidepressants). This is in stark contrast to the situation in youth gender medicine where, to date, there has been no discussion of the placebo effect. Clayton states that “it seems particularly vital to consider the potential role of the placebo effect” of gender-affirming care because the stakes are high.” Medical and surgical interventions, given to vulnerable minors, lead to lifelong medicalization and hold the risk of serious irreversible adverse impacts, such as sterility and impaired sexual function. “Thus, we need strong evidence that they are as efficacious for critical mental health outcomes as claimed and that there are no less harmful alternatives.”

Concluding Thoughts

SEGM welcomes Clayton’s call for greater awareness and discussion of the placebo effect in youth gender medicine. Given the profound risks of gender-affirming interventions, it is imperative that careful thought and debate focus on this issue. From the methods perspective, the placebo effect puts gender medicine studies at a high risk of bias due to both confounding (the anticipation of improvement affects the results, but its effect cannot be separated from the effect of the treatment) and measurement error (if a study participant expects a positive outcome, they will be more likely to make a positive judgement about the outcome, which will bias their self-reported outcome).

SEGM appreciates the challenges of conducting placebo controlled trials in gender medicine, since the effects of the drugs are apparent nearly immediately and thus the use of inert placebos is not feasible. However, other research designs, including comparative research where control groups use other forms of active interventions such as psychotherapy, provide a viable alternative to minimize the placebo effect, as in both instances the study participants may be expecting improvement. SEGM concurs with Clayton's concerns that gender clinic settings, with their strong stated position of superiority of medical and surgical "affirming" interventions, are inherently problematic research sites for generating reliable comparative data on the efficacy of various treatment approaches. We agree that ultimately, “independent reviews by expert clinicians and methodologists" which include gender clinicians as well as those "not currently involved in clinical practice and research in this area (thus, having some emotional distance and minimizing intellectual conflict risk), could helpfully advise further research and clinical strategies.”

Both clinicians and media must reassess their approach to reporting on “gender-affirming” interventions, focusing on measured and honest statements about what is known and not known about the safety and efficacy of gender-affirming treatments. The uncertain and wholly inadequate evidence base for these treatments must be acknowledged. The full range of treatment options and pathways should be presented, including, as Clayton suggests, “realistic positive stories of those with gender dysphoria who have decided not to transition or have delayed transition until maturity; accounts of patients who have benefitted from ethical psychological approaches; and accounts of those who have had negative transition experiences. Detransition, regret, and harm from transition should be acknowledged and publicized as a significant risk."

Finally, in recent months, we have seen an attempt by the gender-medicine establishment to begin to redefine the “affirmative care” pathway away from the previous focus on social transition, puberty blockers, cross-sex hormones and surgery, as articulated in the American Academy of Pediatrics’ 2018 policy, and toward a broader definition of generally supportive care that affirms a young patient’s confidence and self-worth. SEGM welcomes this definitional shift. In a recent statement, the AAP president went on record stating that only a minority of trans-identified youth need hormones and surgery, while the majority need "just the opposite."

If “gender-affirming care” is redefined as an approach promoting “positive clinician-patient interactions” that respect the young person's experience, decrease anxiety, and increases hope—without infusing undue assurance about the safety and efficacy of hormones and surgery—then we can all get behind the idea of “affirmative care.” After all, this is the very reason why positive patient-clinician interactions are the core of healing, even if some of its effects are placebo-induced.

“to begin to redefine the “affirmative care” pathway [..] toward a broader definition of generally supportive care that affirms a young patient’s confidence and self-worth.”

This is, of course, good news.

However, as is always the case with ideologies that extensively utilize gaslighting, we will be reliably informed that it always meant this, that the “panic” over juvenile medicalization and surgeries was a “transphobic” misinformation campaign, and “affirm or die” will be shoved under the carpet like it never existed, along with its deranged lunatics, such as Michelle Forcier, Jack Turban and Eli Erlick.

Quite frankly, I don’t care. The sooner the better, as long as the madness stops. But we will not forget, and we will not forgive.

Hopefully they’ll stop denying basic human biology soon as well.

23 notes · View notes