Podcasts about dsm diagnostic

In this second part of our discussion on 'Biblical Counseling and Mental Disorder Diagnosis' Dr. Jenn Chen and Dr. Ernie Baker join Anthony Russo to further evaluate the DSM (Diagnostic and Statistical Manual of Mental Disorders) from a biblical perspective, exploring its cultural and clinical implications. The conversation delves into how biblical counseling addresses issues of mental health differently than secular psychology, emphasizing the sufficiency of Scripture and the transformative power of the gospel. This episode provides practical advice for pastors, biblical counselors, and Christian parents, encouraging them to stay rooted in biblical truths while addressing modern mental health challenges.00:50 Discussing the DSM and Cultural Implications01:16 Addressing Gender Identity and Paraphilic Disorders02:51 Biblical Counseling vs. Secular Therapy03:35 The Role of Parents in Protecting Children04:56 The Importance of a Biblical Worldview08:58 Information, Interpretation, and Intervention15:20 Encouragement for Biblical Counselors18:39 The Power of the Gospel in Counseling22:06 Concluding Thoughts and ResourcesFollow Shepherd Press on social media for more insights:Facebook: @shepherdpressInstagram: @shepherdpressincGrab a copy of 'Biblical Counseling and Mental Disorder Diagnosis': https://www.shepherdpress.com/products/biblical-counseling-and-mental-disorder-diagnosis/

"Catholic Counseling" is a weekly segment of Morning Light where we've assembled a panel of experts to help Catholics maintain good mental health. Jarrod Crump from Spero Mental Health & Healing joins us today to discuss the DSM (Diagnostic and Statistical Manual of Mental Disorders).

This week, we are joined by Dr. Roger McFillin to discuss the mental health field. We begin by exploring the importance of incorporating a spiritual component into health and the challenges posed by the transhumanist agenda. We also touch on the concept of self-improvement.Dr. McFillin shares a pivotal story that influenced his path as well as his journey in general. Leading to a discussion on the need for accountability among practitioners. This segues into a conversation about the DSM (Diagnostic and Statistical Manual of Mental Disorders) and the issues surrounding diagnosis, with a crucial reminder that many individuals are suffering.The discussion then broadens to address systemic problems within the profession and potential pathways for improvement. Dr. McFillin offers valuable advice for those working in the mental health field.I hope you enjoy the episode!Learn from mehttps://www.instagram.com/beyond.terrain/https://linktr.ee/beyondterrainSupport the visionShare!!!https://www.buymeacoffee.com/beyondterrainETH: beyondterrain.ethBTC: bc1qqwc470ktgj3l4myqxr5hq67rnlqys0qm98u6f0Support and Learn from Dr. McFillinhttps://www.drmcfillin.com/https://thecccollective.org/

In this episode, we cover:The diagnosis process can be fraught. Dr. Richey says that you do NOT need a diagnosis to start giving yourself love and compassion. You don't need a label to understand yourself. The DSM is very limited, and is inadequate when it comes to diagnosing women and girls as well as the BIPOC community. Dr. Richey breaks down the difference between screening and testing, and outlines the different types of practitioners who provide diagnosis. Understanding WHY you are seeking a diagnosis is an important part of choosing the correct path for you. We learn the term "Good girl zone" and how it starts with little girls who can't pay attention in class but pretend they are so they don't get in trouble. "You are neurodivergent, and that's okay. You don't have to do that." Dr. Richey gives us the permission to function differently that we didn't get in childhood. In fact, not only can we be okay, we can be better than ok. Dr. Richey tells us how to prepare for an ADHD evaluation in terms of what to do ahead of time, what to bring, and what to expect. In part one of our incredible conversation with Dr. Rebecca Richey, Psy.D, MBA, LC, SW, MS, CP, CAC-III, who serves as the clinical director for Colorado Women's Collaborative Healthcare, we discuss the complicated process of getting an ADHD diagnosis. She covers the different types of practitioners available, the different options for evaluation, and the obstacles to getting diagnosed, including flaws in the DSM (Diagnostic and Statistical Manual of Mental Disorders) that make women and the BIPOC community more likely to fall through the cracks. She sheds light on what happens when girls are not properly diagnosed with ADHD. Follow Dr. Richey here:https://cowomenscare.com/Download the ADHD Mom Meditation Here:https://www.motherplusser.com/ADHD-meditationHere are the abbreviated notes from Dr. Richey (if you want the whole notes page, email me at hello@motherplusser.com and I will send them to you):Screening vs. testing—any self-completed forms that ask about symptoms is a screener. Doing a self-eval and talking to a professional for a while is a screener or an enhanced screener.Testing/psychological assessment—more in-depth and uses objective measures (vs. subjective). Objective measures being cognitive testing, continuous performance testing, memory testing, executive functioning, collaborative info.Whether you get a screener or an assessment depends on what you want...If you think you have ADHD and want to try medication, a screening with a PCP or psychiatrist is in line. If you want treatment that doesn't involve medication, a screening with a master's level clinician is great.MOTHER PLUS INSTAGRAM: https://www.instagram.com/mother_plus_podcast/MOTHER PLUS FACEBOOK: https://www.facebook.com/motherpluspodcastMOTHER PLUS PERMISSION SLIP: https://www.motherplusser.com/Permission-SlipMOTHER PLUS NEWSLETTER: https://www.motherplusser.com/signup-pageMOTHER PLUS BLOG: https://www.motherplusser.com/blog

Are we all just pawns in the elaborate game of narcissists, or can we learn to see through their facade? This is the question that emerged from a recent episode of the podcast "Hidden Killers," where host Tony Brueski and trauma therapist Heather Boorman delved into the complex world of narcissism. Narcissism, often tossed around in casual conversation, may be more pervasive than we think. Boorman, author of 'A Thousand Paper Cuts,' explained, "Just because there are narcissistic tendencies does not necessarily qualify for an official NPD [Narcissistic Personality Disorder] diagnosis." She emphasized the spectrum of narcissism, from overt to covert, and the challenge of diagnosing based on the DSM (Diagnostic and Statistical Manual of Mental Disorders). Boorman described overt narcissists as those who exhibit grandiosity and a palpable need for admiration. They stand out at social gatherings with their self-centered behavior. In contrast, covert narcissists, while equally self-absorbed, are more insidious, often maintaining a positive public profile and employing psychological manipulations. "The overt narcissist is like a big meteor that hits, and a covert narcissist is like the Colorado River that chips away gradually," Boorman analogized. She explained that victims often don't realize the gradual erosion of their well-being in such relationships. The discussion also covered the motivations behind narcissistic behavior. Boorman outlined three primary goals: seeking supply (to feel their existence through others' reactions), avoiding introspection and underlying shame, and obtaining maximum benefit with minimal effort. Boorman and Brueski also discussed the pattern of narcissistic abuse, which typically follows a cycle of love bombing, devaluation, and discard. Victims often stay for decades, entangled in this cycle, unable to pinpoint the cause of their unhappiness. This enlightening conversation sheds light on a topic often misunderstood and oversimplified. As we navigate our relationships, it's crucial to ask: Are we equipped to recognize and protect ourselves from the subtle manipulations of narcissists? Want to listen to ALL of our podcasts AD-FREE? Subscribe through APPLE PODCASTS, and try it for three days free: https://tinyurl.com/ycw626tj Follow Our Other Cases: https://www.truecrimetodaypod.com The latest on Catching the Long Island Serial Killer, Awaiting Admission: BTK's Unconfessed Crimes, Chad & Lori Daybell, The Murder of Ana Walshe, Alex Murdaugh, Bryan Kohberger, Lucy Letby, Kouri Richins, Justice for Harmony Montgomery, The Murder of Stephen Smith, The Murder of Madeline Kingsbury, and much more! Listen at https://www.truecrimetodaypod.com

Are we all just pawns in the elaborate game of narcissists, or can we learn to see through their facade? This is the question that emerged from a recent episode of the podcast "Hidden Killers," where host Tony Brueski and trauma therapist Heather Boorman delved into the complex world of narcissism. Narcissism, often tossed around in casual conversation, may be more pervasive than we think. Boorman, author of 'A Thousand Paper Cuts,' explained, "Just because there are narcissistic tendencies does not necessarily qualify for an official NPD [Narcissistic Personality Disorder] diagnosis." She emphasized the spectrum of narcissism, from overt to covert, and the challenge of diagnosing based on the DSM (Diagnostic and Statistical Manual of Mental Disorders). Boorman described overt narcissists as those who exhibit grandiosity and a palpable need for admiration. They stand out at social gatherings with their self-centered behavior. In contrast, covert narcissists, while equally self-absorbed, are more insidious, often maintaining a positive public profile and employing psychological manipulations. "The overt narcissist is like a big meteor that hits, and a covert narcissist is like the Colorado River that chips away gradually," Boorman analogized. She explained that victims often don't realize the gradual erosion of their well-being in such relationships. The discussion also covered the motivations behind narcissistic behavior. Boorman outlined three primary goals: seeking supply (to feel their existence through others' reactions), avoiding introspection and underlying shame, and obtaining maximum benefit with minimal effort. Boorman and Brueski also discussed the pattern of narcissistic abuse, which typically follows a cycle of love bombing, devaluation, and discard. Victims often stay for decades, entangled in this cycle, unable to pinpoint the cause of their unhappiness. This enlightening conversation sheds light on a topic often misunderstood and oversimplified. As we navigate our relationships, it's crucial to ask: Are we equipped to recognize and protect ourselves from the subtle manipulations of narcissists? Want to listen to ALL of our podcasts AD-FREE? Subscribe through APPLE PODCASTS, and try it for three days free: https://tinyurl.com/ycw626tj Follow Our Other Cases: https://www.truecrimetodaypod.com The latest on Catching the Long Island Serial Killer, Awaiting Admission: BTK's Unconfessed Crimes, Chad & Lori Daybell, The Murder of Ana Walshe, Alex Murdaugh, Bryan Kohberger, Lucy Letby, Kouri Richins, Justice for Harmony Montgomery, The Murder of Stephen Smith, The Murder of Madeline Kingsbury, and much more! Listen at https://www.truecrimetodaypod.com

Are we all just pawns in the elaborate game of narcissists, or can we learn to see through their facade? This is the question that emerged from a recent episode of the podcast "Hidden Killers," where host Tony Brueski and trauma therapist Heather Boorman delved into the complex world of narcissism. Narcissism, often tossed around in casual conversation, may be more pervasive than we think. Boorman, author of 'A Thousand Paper Cuts,' explained, "Just because there are narcissistic tendencies does not necessarily qualify for an official NPD [Narcissistic Personality Disorder] diagnosis." She emphasized the spectrum of narcissism, from overt to covert, and the challenge of diagnosing based on the DSM (Diagnostic and Statistical Manual of Mental Disorders). Boorman described overt narcissists as those who exhibit grandiosity and a palpable need for admiration. They stand out at social gatherings with their self-centered behavior. In contrast, covert narcissists, while equally self-absorbed, are more insidious, often maintaining a positive public profile and employing psychological manipulations. "The overt narcissist is like a big meteor that hits, and a covert narcissist is like the Colorado River that chips away gradually," Boorman analogized. She explained that victims often don't realize the gradual erosion of their well-being in such relationships. The discussion also covered the motivations behind narcissistic behavior. Boorman outlined three primary goals: seeking supply (to feel their existence through others' reactions), avoiding introspection and underlying shame, and obtaining maximum benefit with minimal effort. Boorman and Brueski also discussed the pattern of narcissistic abuse, which typically follows a cycle of love bombing, devaluation, and discard. Victims often stay for decades, entangled in this cycle, unable to pinpoint the cause of their unhappiness. This enlightening conversation sheds light on a topic often misunderstood and oversimplified. As we navigate our relationships, it's crucial to ask: Are we equipped to recognize and protect ourselves from the subtle manipulations of narcissists? Want to listen to ALL of our podcasts AD-FREE? Subscribe through APPLE PODCASTS, and try it for three days free: https://tinyurl.com/ycw626tj Follow Our Other Cases: https://www.truecrimetodaypod.com The latest on Catching the Long Island Serial Killer, Awaiting Admission: BTK's Unconfessed Crimes, Chad & Lori Daybell, The Murder of Ana Walshe, Alex Murdaugh, Bryan Kohberger, Lucy Letby, Kouri Richins, Justice for Harmony Montgomery, The Murder of Stephen Smith, The Murder of Madeline Kingsbury, and much more! Listen at https://www.truecrimetodaypod.com

If you don't identify with one of the labels in the title, you likely know someone who does. As with all labels, however, they don't completely define us. Those of us who have these patterns are not the same, nor struggle to the same extent.  Still, this psychological construct has been repeatedly recognized in the mental health field. Perhaps because it is so common, you won't find it included as a condition or personality disorder in the DSM (Diagnostic and Statistical Manual of Mental Health Disorders).  Nonetheless, this way of being in the world can be painful and stressful. At the very least, these tendencies can keep us from enjoying the full potential of our lives. In this episode, I discuss:* Overlapping definitions from attachment theory, family systems theory and 12-step programs* Common early experiences * Cultural messages* Suspected genetic variants* Difficulties with boundaries* Communication style* Common behaviors* Common emotions* Education and resources* Parenting our inner childTo receive the newsletter (text and audio) in your mailbox each week, subscribe at: https://www.courtneysnydermd.com or on Substack: https://courtneysnydermd.substack.com/ Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

As the public and policy makers at various levels of government are pressured to double down on punitive status quo approaches, we hope everyone listens to this re-air of Crystal's robust conversation with criminologist Damon Petrich about the ineffectiveness of incarceration.  As lead author of the seminal work “Custodial Sanctions and Reoffending: A Meta-Analytic Review,” Damon performed an extensive analysis of 116 research studies looking at the effect of incarceration on reoffending. The review's finding that the oft-used policy of imprisonment does not reduce the likelihood of recidivism sparks a discussion about how the United States ended up as the world leader in mass incarceration and the disconnect between conventional assumptions about what prisons provide versus reality. Noting that the carceral system does a poor job of rehabilitation - while eating up budgets across the country and exacting significant societal costs - Damon and Crystal talk about how to design and evaluate programs that do work to deliver greater public safety for everyone. As always, a full text transcript of the show is available below and at officialhacksandwonks.com. Find the host, Crystal, on Twitter at @finchfrii and reach Damon for more information about his research at dpetrich@luc.edu   Dr. Damon Petrich Dr. Damon M. Petrich is an Assistant Professor of Criminal Justice and Criminology at Loyola University Chicago. He received his Ph.D. in Criminal Justice from the University of Cincinnati, and his Bachelor of Arts (Honors) and Master of Arts degrees in Criminology from Simon Fraser University. His research focuses on two interrelated areas. The first is the development of antisocial behavior across the life-course, specifically focusing on desistance from crime and the mechanisms by which exposure to community violence impacts self-regulation and behavior. Dr. Petrich's second area of research surrounds the effectiveness of sanctions and programs in the criminal justice system. Throughout these projects, Dr. Petrich uses a wide range of methodological approaches, including qualitative techniques, meta-analysis, machine learning, and marginal structural modeling.   Resources  “Custodial Sanctions and Reoffending: A Meta-Analytic Review” by Damon M. Petrich, Travis C. Pratt, Cheryl Lero Jonson, and Francis T. Cullen for Crime and Justice   Scott Hechinger Twitter thread   “Mass Incarceration: The Whole Pie 2022” by Wendy Sawyer and Peter Wagner from the Prison Policy Initiative   “Risk-need-responsivity model for offender assessment and rehabilitation” by James Bonta and D. A. Andrews for Public Safety Canada   “Let's Take a Hard Look at Who Is in Jail and Why We Put Them There” by Alea Carr for the ACLU-WA blog   Book - “Great American City: Chicago and the Enduring Neighborhood Effect” by Robert J. Sampson   Byrne Criminal Justice Innovation Program - “Police Legitimacy and Legal Cynicism: Why They Matter and How to Measure in Your Community”   “Polls Show People Favor Rehabilitation over Incarceration” by Matt Clarke for Prison Legal News   Transcript [00:00:00] Crystal Fincher: Welcome to Hacks & Wonks. I'm Crystal Fincher, and I'm a political consultant and your host. On this show, we talk with policy wonks and political hacks to gather insight into local politics and policy in Washington state through the lens of those doing the work with behind-the-scenes perspectives on what's happening, why it's happening, and what you can do about it. Full transcripts and resources referenced in the show are always available at officialhacksandwonks.com and in our episode notes. Well, I am excited to welcome Damon Petrich, who's a doctoral associate in the School of Criminal Justice at University of Cincinnati and incoming assistant professor at Loyola University Chicago. He was the lead author of a recent article, "Custodial Sanctions and Reoffending: A Meta-Analytic Review," along with Travis Pratt, Cheryl Lero Johnson, Francis T. Cullen. Damon's research focuses on the effectiveness of corrections and rehabilitation programs, desistance from crime, and the impact of community violence on youth development. Thank you so much for joining us, Damon. [00:01:13] Damon Petrich: Thank you very much for having me on, Crystal. I'm excited to talk a little bit about my work and the implications of that and all that, so thanks again. [00:01:20] Crystal Fincher: I'm very excited to talk about this and it's extremely timely - has been for a while. We have conversations almost every day in the public sphere having to do with public safety - this is such a major component of it. And so I'm hoping as we have this conversation, it'll help us to better assess what the costs and benefits are of custodial sanctions and incarceration, and alternatives to that - to have a conversation that kind of orients us more towards public safety. Sometimes we're so concerned with metrics around police and how many they are, and what the length of a sentence should be. And sometimes we focus on things that take us off of the overall goal of keeping us all safer and reducing the likelihood that each of us are victimized and to hopefully prevent people from becoming victims of crime. And just to have accurate conversations about how we invest our public resources - what we're actually getting from them, and then how to evaluate as we go along - what we should be tracking and measuring and incentivizing. As so many people talk about taking data-driven approaches and create all these dashboards - that we're really doing it from an informed perspective. So just to start out - what actually were you studying and what were you seeking to find out? [00:02:47] Damon Petrich: Yeah, so the main purpose of our meta-analysis, which I can explain exactly what that is later on if you have questions, but the main purpose was to understand what happens when you take one group of offenders and you sentence them to something custodial like prison or jail, and then you sentence another group of similar offenders to something non-custodial like probation. How do those two groups differ in terms of whether they reoffend? So does prison actually deter recidivism, or does it make people more likely to commit crime afterwards? So that's sort of what we were looking at and so we considered all of the available research on that, in this review. [00:03:29] Crystal Fincher: Got it. So right now we have gone down the path of mass incarceration - that is the default punishment that we, as society, have looked to for crime. Hey - sentence them and many times it's, Hey, they're going to jail. Sometimes they get out of jail and they have supervision that continues, but jail is really focused, where we focus a lot of our effort and where we put people and hope that that'll straighten them out and they come out and everything is fine. How did we get here and where are we in terms of how we're approaching incarceration in our society, in our country? [00:04:11] Damon Petrich: Yeah, so there is a lot of public uproar around a lot of issues, like race issues, and there was crime spikes and concerns over social welfare - and there's all this confluence of issues in the '60s and early '70s. And we decided to - as a country, not everyone, but politicians decided that we should tackle the crime problem by A) incarcerating more people, and then B) once they get there, keep them there for longer. So we enacted things like mandatory minimum sentences, where the judge really has no discretion over what happens - the person gets automatically a sentence of incarceration if they've committed a certain type of crime. You had habitual offender laws where if you're - like California's three strikes policy - where if you have two prior felonies and you get a third, no matter what it is, you're going to jail for life. Michigan had the "650 Lifer Law," where if you get caught with 650 grams of heroin or cocaine, you're automatically going to prison for life. And then we got rid of parole and stuff like that in a lot of states. So all these things lead to more people going to jail and then for longer, and those laws came to be in the '70s and '80s. And over that time, our incarceration rate ballooned up by about 700%, so by the early 2000s, we were at over 2 million people incarcerated and another 7-8 million people on probation or parole. So it's a pretty big expansion - the United States has 5% of the world's population and a quarter, or 25%, of the prisoners, so it's a little ridiculous. The crime rate here isn't nearly as high, or nearly high enough to justify that huge disparity. So yeah, it's a whole confluence of factors led us to be the world leader in incarceration. [00:06:14] Crystal Fincher: And what attitudes or what justifications are the people who have the power to enact these policies and continue these policies - how are they justifying them? [00:06:25] Damon Petrich: So there's a few reasons why you might want to incarcerate somebody. One is just because you want to punish them or get revenge on them, so that's more of a moral reason. But the main focus of politicians were twofold - one was incapacitation, so that one means that because you're keeping somebody locked up in a cage, obviously they can't be out in the community committing crimes. So the thought is that you're going to reduce crime that way. The research on that is a little squishy even now, and I can talk a little bit more about that later if you want. But the other reason, and the one that we focused on in our review, was that prison deters people from going back to crime after they get out. So the idea there is that prison sucks - you go in there, you're cut off from your job, from your family, from your friends, or from just having hobbies or things to do. And you're not going to want to go back, so when you get out of prison - you think real hard, and you think how much prison sucks, and you decide not to go back to crime. That's the thinking behind that deterrence hypothesis anyway. So those two - incapacitation and deterrence - were the main drivers of those increase in laws and stuff during the '70s, '80s, and '90s, but there really wasn't any evidence for either of them - in the '70s and '80s in particular. So most of the research evaluating whether prison actually does deter recidivism has popped up over the last 25 years or so. [00:08:05] Crystal Fincher: And as you took a look at it - all of the studies that have popped up over the past 25 years had varying degrees of rigor and scientific validity. But as that body of research grew, people began to get a better idea of whether incarceration actually does reduce someone's likelihood of reoffending. How big was that body of work, in terms of studies, and what were you able to look at? [00:08:40] Damon Petrich: So in our particular review, we looked at 116 studies, which is a pretty sizable number. Most people - when you read through an article and a literature review might have 10 studies or something that they just narratively go through, but we looked at 116. And then within those 116 studies, there were 981 statistical models. So 901 different comparisons - or 981 different comparisons - of what happens to custodial versus non-custodial groups. So we looked at a pretty big chunk of literature. [00:09:20] Crystal Fincher: And in that, in the reliance of - that's a really big number - and I think, people now are maybe more familiar, just from a layperson's perspective, of just how big that number is. As we've seen throughout this pandemic that we're in the middle of, studies come out - people are looking at one study, and wow - study number two comes out and we're feeling really good about it. And man, we get to five studies and people are like, okay, we know what's going on. To get beyond a hundred is just a real comprehensive body of study and analysis. What were you able to determine from that? [00:10:05] Damon Petrich: So I should probably explain upfront what a meta-analysis is and why it's useful. So like you were just saying - like in the COVID pandemic, for example - one study will come out and it'll say, oh, Ivermectin reduces symptomatic COVID cases by X percent. And then the next study will come out and say, Ivermectin makes people way worse. So any individual study can be kind of misleading. A good analogy for what a meta-analysis does would be to look at baseball, for example. So let's say you're interested in some rookie player that's just come out, he's just joined Major League Baseball and you go to his - you want to know how good this player actually is? You've never seen him play, you've only heard rumors. So you go out to his first game, he gets up to bat four times and he gets no hits. So you walk away from that game thinking, wow, this player is terrible, the team wasted all their money recruiting and paying this guy's salary. But that could have just been an off game for many reasons - it's his debut game so maybe there's just first-game nerves, maybe the weather was bad, maybe he was having personal problems in his life, or he had a little bit of an injury. So there's a number of reasons why looking at his performance from that one game is not going to be representative of who he is as a player. Ideally, you'd want to look at all the games over a season where he might go up to bat 250 times. And over those 250 times, he gets 80 hits, which is a pretty good batting average - it's over .300. So with that amount of data, you could come to a more solid conclusion of whether he's actually a good player or not. And with that amount of data, you could also look at what we call moderating characteristics. So you could look at, for example, whether he plays better when it's an away game or in a home game, whether it's early or late season - you could look at all these sorts of things. So this is essentially what we're doing with research as well, in a meta-analysis. So if you look at studies on incarceration - one might show increases in recidivism after people go to prison, the next might show decreases, and the next might show that probationers and prisoners reoffend at about the same rates. So just like in the baseball analogy, in a meta-analysis, we're looking at all of the available research. We're combining it together and determining A) what the sort of overall or average effect of incarceration is, and then B) whether these moderating characteristics actually matter. So in other words, is the effect of incarceration pretty much the same for males as it is for females, or for juveniles as adults, or when the research design is really good versus when it's not so great. So that's basically what we did in this meta-analysis is again - looked at 116 studies and from those 981 statistical estimates. [00:13:13] Crystal Fincher: Very helpful. Totally makes sense with the baseball analogy, and I especially appreciate breaking down with all the statistical models and not just kind of thumbs up, thumbs down - the binary - it either increases or reduces the likelihood of recidivism. But under what conditions are - might it be more likely, less likely that someone does? What are some of those influencing effects on what happens? And so you were just talking about the justification that people used going into this, and now that we have data coming out - does it turn out that people go into prison or are incarcerated in jail, they think - wow, this is horrible. Some in society are like the more uncomfortable we make it in jail, the better we want to make sure it's a place that they never would want to come back to - that it's so scary and such a bad experience that they are just scared straight for the rest of their lives. Does it actually turn out to be that way? Do they take a rational look at - this was my experience, I don't want to go back again, therefore I will not do any of the things that I did going in. [00:14:28] Damon Petrich: I would not say that's the conclusion - no. So again, based on the 116 studies that we looked at, which is again a lot, people who are sentenced to incarceration - so jail, prison - they commit crime, they reoffend at about the same rates as if you'd sentence those same people to probation. So in other words, they're not being deterred by being sent to prison. These effects are the same for both males and females. So in other words, prison doesn't reduce reoffending for one group versus the other. It's the same whether we look at adults versus juveniles, it's the same regardless of what type of recidivism we're interested in - rearrests or convictions. It's pretty much the same across the board. There's some slight variations in research designs, but even within those, prison either has no effect or it slightly increases recidivism. We don't find any conditions under which prison is reducing reoffending or deterring these people from going back to those lives. [00:15:35] Crystal Fincher: So from a societal perspective, a lot of people kind of make the assumption that, Hey, we arrest and we incarcerate someone - whew, our streets are safer. They get out, and now they can choose to reintegrate themselves into society hopefully - they do and we're all safer because of it. But it looks like impressions that some people may have that, Hey, we're letting someone off easy. And suggestions - there's so much media coverage around this - and suggestions that because we're letting people off easy, that we're making it easier for them to reoffend, or they don't feel sufficiently punished enough and so that becomes an incentive to reoffend. Does that seem like it tracks with what the studies have shown? [00:16:33] Damon Petrich: Not really - so there's some studies that actually ask prisoners and offenders whether they'd prefer going to prison or probation. And a lot of them will say, oh, I'd rather do a year in prison than spend two or three years on probation. So it's not like they view probation as just being super easy. And they're not saying this because they received time off their sentence for being in the study or anything like that. Probation's not easy either - and you have to also think that while these people are on probation, they're able to stay in close touch with their family, they're able to maintain connections with work or find work, they're able to participate in the community, they can pay taxes - that I know a lot of people who are pro-prison love. So there's all sorts of reasons why - beyond just them reoffending at the same rates as if they'd gone to prison - there's a lot of reasons why we might want to keep these people in the community. And it's not like we're saying, let everybody out of prison - so the nature of this research - you want to compare apples to apples. So in this research, comparing prisoners to probationers - these have to be people who are getting - they could either legitimately get a sentence of jail or probation, or prison or probation. So these are going to be first-time offenders, people who are relatively low-level - they've committed low-level crimes and all that. So we're not saying - there's not going to be a situation where a murderer just gets probation - that sort of thing. So I know that might be a concern of some people - they think that's a natural argument of this analysis, but it's really not. [00:18:24] Crystal Fincher: Well, and to your point, we're really talking - if we're looking at all of the crime that gets people sentenced to prison time, a very small percentage of that is murder. A very small percentage of it is on that kind of scale - you can wind up in jail or prison for a wide variety of offenses - many of them, people perceive as relatively minor or that people might be surprised can land you in prison. Or if someone has committed a number of minor offenses, that can stack up - to your point in other situations - and increase the length of detention or the severity of the consequences. As we're looking through this and the conversation of, okay, so, we sentence them, we let them out - it's not looking like there's a difference between jail or community supervisions, things like probation - what is it about jail that is harmful or that is not helpful? What is it about the structure of our current system that doesn't improve recidivism outcomes for people? [00:19:42] Damon Petrich: Probably the main one is the rehabilitation is not the greatest. So just as an example, substance abuse is a very strong predictor whether people are going to reoffend, unsurprisingly. About 50% of prisoners at the state and federal level in The States meet the DSM [Diagnostic and Statistical Manual of Mental Disorders] criteria for having a substance use abuse disorder - so they meet the clinical criteria for substance abuse disorder. So half of them, and then more than that just use substances, but they don't meet the criteria for a disorder. But of that 50% who has a substance abuse disorder, only about 20% of those actually receives treatment for it while they're incarcerated. So, you're not dealing with a root cause of reoffending while they're in prison - so you're not deterring them, but you're also not rehabilitating them - so you're really not doing anything. And then in the rare cases where these people are provided with rehabilitation or reentry programming, it's often not based on any sort of evidence-based model of how you actually change people. So there's a lot of psychological and criminology theory and research on how you actually elicit behavioral change, and these programs really aren't in line with any of that. And I could give examples if you wanted, but - [00:21:17] Crystal Fincher: Sure. I think that's helpful, 'cause I think a lot of people do assume, and sometimes it's been controversial - wow, look at how much they're coddling these prisoners - they have these educational programs, and they get all this drug treatment for free, and if they don't come out fixed then it's their own fault because they have access to all of these treatment resources in prison. Is that the case? [00:21:43] Damon Petrich: No, I wouldn't say so - first of all, they don't have access, a lot of them, to any programs. And then, like I said, the programs that they do get really aren't that effective. So the big one that everybody loves to argue for is providing former inmates with jobs. If you look at any federal funding for program development, like the Second Chance Act or the First Step Act - I think that was one under Trump - and then under Bush, there was a Serious [and] Violent Offenders Reentry Initiative - pretty much all of these federal bills will be heavily focused on just providing offenders with jobs. And almost all of the evaluations of these programs show that they don't reduce reoffending. And it's not really that hard - again, if you go back to the literature on behavioral change and, criminology literature - it's not really that hard to understand why just providing a job isn't going to reduce or lead somebody away from a life of crime. A lot of these people have spotty work histories where they've never had a job at all, they believe and know that it's easier to gain money by doing illicit work than it is legal work, they have things like low self-control so they're very impulsive, they don't know how to take criticism or being told what to do by a boss. They live in neighborhoods with very poor opportunities for good jobs and education, and maybe there's a mindset around there that illegal work or whatever is just a better way to go - that's sort of ingrained. So there's a lot of different reasons why just handing somebody a job isn't going to lead them away from crime, 'cause they have all these other things that need to be dealt with first. So ideally, a rehabilitation program that's comprehensive would deal with all of those other background factors and then provide them with a job. Because if you make them less impulsive, better able to resist the influence of their antisocial friends, and get this thought out of their head that other people are being hostile towards them when they're really not - all these sorts of cognitive and behavioral biases that they have - if you deal with all of those things and then you give them a job, they're more likely to actually latch onto that job as something worthwhile doing. And then they're going to go on to get out of a life of crime. But if you just give them a job and you haven't dealt with any of those issues, you can't really expect that to work. And that is the model that we currently do - is something that we don't really expect to work that well. [00:24:28] Crystal Fincher: Yeah, that's - it's really interesting and I don't know that a lot of people actually know that, Hey, giving someone a job isn't sufficient - which is why I think it's so important to talk about studies like this, because some of what has become conventional wisdom, really is not accurate or reflects what has been studied and discovered. And I guess in that vein, what are the factors - you just talked about a few - but what does increase someone's likelihood of reoffending or recidivism, and what reduces it? [00:25:08] Damon Petrich: So those are probably two ends of the same, or two sides of the same coin, but this is pretty well known in criminology - a model called the risk-need-responsivity [RNR] model was developed by a couple of fellow Canadians, named James Bonta and Don Andrews, along with some of their colleagues in the '80s and '90s. And they, through again, other meta-analyses just like we did, found certain categories of characteristics of people who are more likely to reoffend. So you have things like having antisocial peers - so that one's pretty obvious - if you have a bunch of friends that are involved in crime, it's going to be pretty hard for you to get out of that life because you're surrounded by those people. Same with family members. If you have what are called criminal thinking patterns - so again, you might have what's called a hostile attribution bias, things like that, where somebody says something a little bit negative to you and you take that as a huge insult and you retaliate with anger and aggression - things like that. Or being impulsive - so you're again quick to anger, you're swayed by small little enticements in the environment and that sort of thing - so you're easily swayed one way or the other. Things like that are strong predictors of reoffending. Substance abuse - it's what I mentioned earlier. If you don't really have any sort of proactive leisure activities, like hobbies and stuff like that. So there's a bunch of well-known things that we know are strongly associated with recidivism, and a rehabilitation program should ideally deal with them. Now this model that Andrews and Bonta and all these other people came up with - this RNR risk-need-responsivity model - the risk part says that we should give people a risk assessment when they're entering prison or leaving prison and determine what level of risk are they from reoffending. And we assess these different criteria, like criminal thinking patterns and antisocial friends and substance abuse. So we determine what those factors are and then we design them a treatment program that actually deals with those factors at the individual level. So we're not just giving a blanket rehabilitation program to everybody, and you're providing the most amount of care to the people who most need it or who are the most likely to re-offend. And then once we've done all that, we need to make sure that we're addressing these problems in some sort of a format that we know actually works. The most well-known one, but not as often used, the most well-known within the sort of psychologist and criminological literature is cognitive behavioral therapy [CBT]. So this is pretty popular for dealing with depression and all sorts of eating disorders and substance abuse problems in non-offender populations. Well, those programs also work in offender populations and they work pretty well. So the research shows - again meta-analyses - that when you deal with all these three factors - risk, need, and responsivity - you can reduce reoffending rates by about 26%. So it's a pretty sizeable amount - it's much greater than you're getting by just sentencing people to prison without doing anything. [00:28:42] Crystal Fincher: Absolutely, and I think you cover in your paper - those things are absolutely true. And you just talked about several administrations' attempts to implement programming and resources to try and help people get jobs, potentially - hey, there's even a CBT treatment, but if that treatment has twice as many people as are recommended being in a session and occurs over half the time that it's supposed to, you really are sabotaging the entire process or really setting it up for failure. And it just seems to be an expensive exercise that we aren't really getting anything out of. Does that seem to be consistent with how you've seen the attempts at introducing this programming within prisons and jails? [00:29:40] Damon Petrich: Yeah, for sure - this is a pretty common finding too - so it's not just about preaching that you're going to do these things. You actually have to implement them well. So just like you said, there's a number of studies that show this - so you've designed some really great program that deals with all of these risk factors that lead people back into reoffending, you give it to them in a cognitive behavioral setting. So all seems good on paper, but in practice, like you said - one of the famous studies there - can't remember the names of the authors offhand right now - but one of the famous studies there showed that they're providing it to people in groups of 30, as opposed to 15, and they're delivering it in a really short amount of time. And they're not maybe giving it to the highest-risk people - so they're just mixing random people in there at varying levels of risk. So when you do all these sorts of things - you implement the program poorly - you can't really expect it to work. And this is often the case - is the government pays people to come up with these great programs, and then not enough funding is provided to actually make sure that they're implemented and evaluated well. So the amount of funding that actually goes into that - developing the programs to begin with - is small, but when you do do that, you're not making sure that you're actually implementing things well. So it's just sort of shooting yourself in the foot, and probably making people come to the conclusion that these things don't work - when they do work, if you just implement them well. [00:31:17] Crystal Fincher: Yeah, and there's also a lot of rhetoric - and you discuss this - there's a lot of rhetoric coming from the government, even coming from leadership within the Bureau of Prisons or leadership in our carceral system, saying we do want to rehabilitate people. We are trying to implement programming that does this. You see - we have these educational opportunities and we are doing evaluations of people. And it may be happening while they're understaffed or other challenges, but one of the biggest, I guess, red flags is that none of the evaluation of their programs and none of the incentives that arise are in any way tied to what is the actual result of what happens. Are you actually succeeding on reducing someone's likelihood for reoffense? It does not seem like any compensation is tied to that, any kind of evaluation of positions or regular reporting - to say, is this program having its intended effect? And if not, what do we need to do to correct for that? Is that what you found? [00:32:33] Damon Petrich: I would say that's probably a pretty fair assessment. A lot of the programs that are implemented are never evaluated at all. And then the ones that are - it's usually once - there's one evaluation of those programs. And then, like you said, there doesn't really seem to be a lot of self-reflection - I don't know what other word you would use - but these programs don't really change on the basis of these evaluations. So, it's kind of disheartening to hear about, I guess. [00:33:14] Crystal Fincher: It feels very disheartening to live in the middle of - and one of the big things about this is that this - we have these conversations and we talk about these studies and we're saying, yeah, it actually - we're not doing anyone any favors right now when it comes to reducing recidivism. And having these conversations oftentimes detached from the cost associated with what we're paying for these. And my goodness are we paying to incarcerate people? It's not just, well, we do lock them up and we keep them away. Or we do a good job of keeping them in - they reoffend, they go back to jail. And lots of people are like, we did our job, they went back to jail - boom, everything is fine. But we are paying through the nose and out the ear for this - just here, we're in the state of Washington, and right now the state spends about $112 per day, or over $40,000 annually, to incarcerate one individual - that's the cost per inmate. In King County - the county that we're in - they spend $192 a day, or $70,000 annually, to incarcerate an individual. That is a huge amount of the tax dollars that we spend - these come out of our general fund, meaning that these are dollars that every service, everything that is not a dedicated source of revenue, is competing for. So when we talk about things and have conversations like, well, we don't have the budget for that and we don't have the money - that is related to how much of that money we're spending on other things. And my goodness, I would think that we want to get our money's worth for that level of expenditure. And it really appears that if we're saying the goal of jail is to get people on the straight and narrow path and becoming contributing members of society and all of the implications of that, it doesn't seem like we're getting our money's worth. And so, if those aren't the goals and if we just want to punish people, it's not like we're punishing people for free. We're punishing people at the cost of $70,000 per day [year], and at the cost of all the other services and infrastructure needs that we have. So it really seems like we're punishing ourselves as much, or more, as others - particularly if we're bringing people back into society that are likely to reoffend in one way or another. And so if our goal is to keep our community safe and that is the North Star, it looks like we need to realign our processes and our expenditure of resources. I guess my question to you, after all that, is - how should we be moving forward? What should we be looking to do? What is shown to work? [00:36:24] Damon Petrich: Well, I would say - yeah, $70,000 a year as just a revenge cost per person seems like a lot. $80 billion in the country as a whole, for a revenge cost, seems like a pretty high price to pay, given we're not reducing reoffending. You could make the argument that these people aren't offending while they're in prison, but that's - there's other reasons why that might not be completely accurate, which I could talk about too, but - [00:36:59] Crystal Fincher: Well, I'm interested in that. Why might that not be accurate? [00:37:03] Damon Petrich: So, obviously the person - if you incarcerate a particular individual, obviously they can't be out in the community committing crimes. So that's obvious, but there's a number of reasons why that might not, en masse, actually reduce crime a whole lot. The research on it - this is a little bit squishy - in terms of whether incarcerating more people leads to lower crime rates, because one influences the other. But for example, if you look at illegal drug markets - a lot of the homicides in the United States and other violent crime that people are really concerned about, and it's plastered all over the media is - homicides, gang-related stuff. So if you take key gang members out and you put them in prison, what ends up happening is that there's competition in that market to take over that person's place, either within the gang or other gangs coming in. So what ends up happening oftentimes is a spike in violence. So that's one reason why just incapacitating, particularly high-crime individuals, might not actually lead to lower crime rates overall. Again, you're lowering crime for that one person, but you might be increasing crime on a more systemic level. Beyond that, these things have broader societal and community level impacts - incarcerating a lot of people. Again, research shows that when you're incarcerating a lot of people in a particular community - so there's a bunch of really good work by Robert Sampson - he has a book that came out a few years ago called Great American City. And he looked at these individual neighborhoods in Chicago over time, and what he finds is that in communities where there's a higher number of people incarcerated in a particular community, this ends up increasing what's called "legal cynicism." And this is done in some other work as well with David Kirk and Andrew Papachristos - but they show that this increases legal cynicism, which means people are skeptical of police helping them out, the police doing a good job. And what ends up happening after that - when people are more cynical of the legal system, they're less likely to report crimes to the police, they're less likely to cooperate with the police. So what ends up happening? You incarcerate more people and people in that community end up being less willing to cooperate with law enforcement. And this leads to sort of an endless cycle where things sort of get out of hand. So there's all these unintended and nonfinancial consequences of incarcerating a lot of people that could potentially end up leading to more crime. [00:40:03] Crystal Fincher: Well, and - speaking as a Black woman - obviously, looking at the impacts of mass incarceration in the Black community and in neighborhoods around the country - where it is almost like the community is responding to the actual outcome and that, Hey, this actually isn't making my community any better. I'm experiencing traumatic impacts from this - whether it's my relative went to prison or a sole breadwinner in the family and now we're thrown into poverty, or I'm in a situation where I don't have a parent who used to be there - who now is no longer there. Or causing instability and impacting the education that people get and the kind of job opportunity, watching someone who's come out have to struggle and be ostracized. And it looks like, Hey, this is just the first step on a long cycle of traumatic and undesirable events - and I don't want to participate in a system that is doing that. With that, as we look forward, and I think this is also related to conversations about just fundamental trust in our criminal legal system and relations with police and throughout the system. It's - if we think about how to turn that around - to me, seems related to thinking about the question of how do we get better outcomes for everyone? 'Cause it seems like right now where we're investing a lot in poor outcomes for people who were already, usually, in pretty poor spots leading to themselves being incarcerated, coming out and not necessarily improving, definitely not improving. And if anything, a chance that it gets a little bit worse. How do we change that entire outcome? And I know you're looking specifically in the incarceration space, but what should be, what could be done differently? Or do we just need a fundamental restructuring of the way we do this? [00:42:17] Damon Petrich: I don't know about a fundamental restructuring - I don't, I'm not great at that high-level thinking stuff, but what I do know is that - we're probably going to continue to incarcerate people. That's something that's done in every country and people seem to love here. So if we actually want to use prison for public safety - because 95% of inmates eventually get out - if we actually want to use it for public safety, then let's actually try wholeheartedly to rehabilitate them while they're in there. And again, there's a lot of theory and evidence-based principles on how we can do this, like the risk-need-responsivity model that I talked about earlier, cognitive behavioral therapy more broadly. If you use these types of things and continue to work on them and develop them over time, then yeah - prison might actually be helpful if people are going there and getting the help that they need. But that's not what's happening currently. So that's one level in incarceration terms - that's the area that I know best. So that's one way you could potentially alleviate some of this stuff is - if people are actually getting resources and stuff when they're in prison, and then when once they're reintegrating, they're not only going to reoffend less, but maybe they're going to contribute to their community more. They're going to be better able to connect with their family and stuff like that. So rather than being a hindrance, it could potentially be a help. Obviously, again, it's not ideal to remove people from their communities and their family and friends. And like I said earlier, if you have the option to sentence them to something community-based instead, I think that's the better route to go. But if you are going to send people to prison, which I think we're going to continue to do a lot of the time, then let's rehabilitate them while they're in there is the main point. And do so based on what actually works to do that. [00:44:23] Crystal Fincher: It's really the investment in the people who are there, and we're - I think up against a lot of societal attitudes and resistance where it just feels wrong to a number of people to be providing services and shifting that investment to things that are seemingly helpful for the inmate, because everything about how we've been conditioned to understand our prison system has been - the punishment is kind of the key, and they'll make rational decisions afterwards to avoid prison based on how bad the punishment is. When it comes to community supervision, things like probation, what are the differences there? If there are better outcomes from that, what accounts for the better outcomes when it comes to probation versus incarceration? [00:45:23] Damon Petrich: I wouldn't say the outcomes are better - they're just pretty much the same as they would be if they're sentenced to prison. So, probation costs less and then it also enables the people to be out in the community doing community things, like being with their friends and families and all that. I mean, you can't quantify, based on a recidivism percentage, what their family members and friends and employers are getting out of it. So that's something we can't really look at - or I guess you could, but something we don't often do - but so there's intangible things that you would get by keeping people in the community. Plus it doesn't lead to all that other stuff I talked about where people become cynical of the legal system and it leads to this cycle of whatever. [00:46:11] Crystal Fincher: Yeah, and so if we're were doing this programming in prison and helping people, I think your research shows it's extremely important to do both the structural, Hey, you need a place to live, you need to be able to pay your rent and your bills - so having a job, having housing, having healthcare, getting those very basic needs met is critical. But also addressing a number of the mental or behavioral health issues that are common among the incarcerated population - and dealing with that is as important. And basically those two things both need to happen hand-in-hand. How do we do a better job of that in our current system? [00:46:57] Damon Petrich: Well, first of all, I'd like to say that you're right there - I think maybe when I was talking earlier about employment, it might sound like giving people jobs is just a waste of time, but that's not the case. It needs - the two things need to be paired - you need to deal with the cognitive and behavioral problems in addition to giving them jobs and housing support and all that. In terms of how you actually go about doing that, there are examples in the literature of programs that do this, so there's examples out there. I think if you're a state or local or even federal correctional department and you're interested in doing this - implementing something that's evidence-based - or if you're just a concerned citizen that wants to rally your local officials to do that - go and talk to researchers like me, or people at universities that have criminology departments or criminal justice departments, because this knowledge is out there. It's widely available. You just have to go and seek it out. So at my university, for example, we have the University of Cincinnati Corrections Institute and under the guidance of Ed Latessa, he was - now passed - but he was, over the last 30 years, responsible for disseminating a lot of this evidence-based practices to some of the state and local criminal justice agencies. And they helped with implementation and evaluation in a lot of these places, so the help is out there. You just have to look for it a little bit. [00:48:38] Crystal Fincher: And another question I had - your analysis seemed to suggest that when we're talking about low-risk, medium, and high-risk offenders - or people who have done relatively minor crimes versus those who have done more serious crimes - that these interventions are particularly effective the more serious the offense or crime has been. And that perhaps even sometimes treating someone who is a really low-risk as if they're a high-risk, can worsen the outcomes for that person. Is that the case? [00:49:21] Damon Petrich: Yeah, that tends to be a finding in research - we're not exactly sure why, but providing a lot of really intensive services to people deemed to be low-risk can actually be harmful rather than helpful. We don't know based on research why, but there's a lot of pretty good hypotheses about why. So a low-risk offender is going to be somebody who's a first-timer who's committed some not-that-serious crime. So they probably have a job, they probably have pretty strong connections with their family and all that. So if you're taking them and you're putting them in a program where you have to be there 40 hours a week, they're probably going to get fired from their job, it's going to be harder to stay in contact with friends and families that are sort of tying you into a non-criminal life. And then you're probably going to be associating with all kinds of people who are high-risk, and maybe they're going to draw you towards, oh yeah, I could earn four grand going out tonight and stealing some laptops. There's a lot of reasons why just taking low-risk people and putting them in these programs is going to be harmful rather than helpful. [00:50:31] Crystal Fincher: And so with that in mind, and you talk about, Hey, if we're trying to influence local electeds - one of the interesting things about having a podcast and radio show that caters to extremely politically and civically inclined people is that we actually do have a number of policymakers and politicians who listen, and people who are enacting and in control of this policy. If you were to talk to them and give them advice about how to move forward, especially in the current environment that we find ourselves in, where over the past few years has been increasing awareness of some of the defecits of our system and pushes to change those. And also, as we have seen more recently, a real strong pushback from a lot of people who are invested in our current system saying, Hey, let's not change things too much. Maybe we need to jail more and for longer. And maybe we're just not doing enough incarceration, and that's the answer. In that kind of political environment, what would you tell people who are in charge of this policy, who may be facing pressure to keep going forward with the status quo, about how they should evaluate how they should move forward and the kinds of things that they should do? [00:52:07] Damon Petrich: I know a lot of these politicians get lobbied by correctional officer groups or whatever, and that's whatever, but ultimately you get voted in by voters. So, I'm not an expert on public opinion - I have other friends who are more into that kind of stuff, but I do know from talking with them and from reading that literature, that the public actually does support rehabilitation. So they have for a long time and it's shifted more towards being in support of rehabilitation over time. So right now, most Americans support providing rehabilitation programs to prisoners and offenders. So this is something that's going to please your constituency, people want this kind of thing. And it's not like you're going to be losing all kinds of jobs by getting rid of prison - there's going to be a need for skilled people who can provide these programs and probation officers and all these sorts of things. So it's not a net loss when you're getting rid of prisons. There's a lot of reasons to sentence people to community supervision and things like that - provide rehabilitation. There's public support for it, there's jobs involved, there's cost savings - big time, obviously - it's way cheaper to keep somebody out of prison than it is to keep them in prison. So there's a lot of different reasons why you would want to do that as a politician. [00:53:43] Crystal Fincher: I think that makes sense. Certainly it's a lot cheaper to keep someone out of prison versus in prison. I mean, we talked about the annual costs - in the state of Washington over $40,000, King County over $70,000 - comparing that to how much we invest in a student of $11,500 a year. If we focus more on investing in people, both inside and outside the system, it seems like we set ourselves up for a safer community, fewer people being victimized, and more people leading thriving, productive, tax-paying lives. And we're all happier than we are right now, I would think, I would hope - it seems like the research points in that direction. So I certainly appreciate you taking the time to speak with us about this. Is there anything else that you want to leave with us, in thinking about this study and your research? [00:54:55] Damon Petrich: I think we covered it pretty well. Just to circle back to something you just said - I know this might put me out of a job since I focus on what happens when people's lives go awry, but you really are better off to invest in early prevention programs and giving people a good start on life than trying to correct the program or the problem afterwards. So yeah - politicians spend some money on prevention programs. I know the good effects of that are a long way out, but they're actually good on a societal level. So I guess I would add that, even though it's not good for criminologists, maybe, to put themselves out of a job like that. [00:55:40] Crystal Fincher: Well, much appreciated, and thank you so much for having this conversation with us today. [00:55:45] Damon Petrich: Yeah, thank you very much for having me on. I'm glad that there are people out there interested in this stuff, so thanks again. [00:55:51] Crystal Fincher: I thank you all for listening to Hacks & Wonks on KVRU 105.7 FM. The producer of Hacks & Wonks is Lisl Stadler with assistance from Shannon Cheng. You can find me on Twitter @finchfrii, spelled F-I-N-C-H-F-R-I-I. Now you can follow Hacks & Wonks on iTunes, Spotify, or wherever else you get your podcasts - just type "Hacks and Wonks" into the search bar. Be sure to subscribe to get our Friday almost-live shows and our midweek show delivered to your podcast feed. If you like us, leave a review wherever you listen to Hacks & Wonks. You can also get a full transcript of this episode and links to the resources referenced in the show at officialhacksandwonks.com and in the episode notes. Thanks for tuning in - we'll talk to you next time.

In fact 1 - 2 % of people are diagnosed with Autism. That's between 80 to 160 million world wide.  6 - 7 % are diagnosed with ADHD. That's another half a billion. And 20 % of population is considered to be highly sensitive. Another 2 billion. Not considering all the other people facing anxiety, depression or other conditions. Using medical literature, we label a majority of them as “mentally ill”, just like having heart disease or diabetes and treat them with modern medication and pharmaceutical drugs. We must admit the disastrous fact that today we reached a point in our society where we might have created widespread illness by ourselves.  Neurotypical equality, functionality and meritocracy are the norm that we trust. Diagnostic manuals such as the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders) are our holy bible. Official institutions like the American Psychiatric Association are our church. From this angle, we have long since found ourselves in a global pandemic of mental illness that is continuously spreading. The Neurodivergence pandemic. But how could we reach the point where suddenly so many of us face diagnosable mental disorders? Is everyone of us today mentally ill? ► Links and Resources: Elon Musk: https://theconversation.com/elon-musk-how-being-autistic-may-make-him-think-differently-194228  Emma Watson: https://www.facebook.com/adhdfoundation/photos/a.1496504137265052/1608152719433526/?type=3&theatre Mental illness definition: https://www.psychiatry.org/patients-families/what-is-mental-illness History of mental disorders: https://en.wikipedia.org/wiki/Mental_disorder#History Neurodiversity: https://en.wikipedia.org/wiki/Neurodiversity Autism Rights Movement: https://en.wikipedia.org/wiki/Autism_rights_movement Transgenerational trauma: https://en.wikipedia.org/wiki/Transgenerational_trauma War children: https://en.wikipedia.org/wiki/War_children DSM: https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders ICD: https://en.wikipedia.org/wiki/ICD-11 ADHD: https://en.wikipedia.org/wiki/History_of_attention_deficit_hyperactivity_disorder Diagnostic criteria autism: https://pages.uoregon.edu/eherman/teaching/texts/DSM-I%20-%20DSM-IV%20diagnostic%20criteria.pdf Making money statement: https://karger.com/pps/article-abstract/75/3/154/282469/Financial-Ties-between-DSM-IV-Panel-Members-and?redirectedFrom=fulltext Fashion diagnoses: https://www.autismusspektrum.info/post/wunschdiagnose-bzw-modediagnose-autismus-bei-erwachsenen ► Subscribe On Your Favorite Platform!  YouTube: ⁠https://www.youtube.com/channel/UCGiJdF0yeTyRJanW_uSICDw?sub_confirmation=1⁠ Spotify: ⁠https://open.spotify.com/show/2gaheQLxBwByM9txVzlpI6⁠ Apple Podcasts: ⁠https://podcasts.apple.com/us/podcast/understandable/id1399616905⁠Google Podcasts: ⁠https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy9kYzYwNTY2Yy9wb2RjYXN0L3Jzcw⁠Amazon Music: ⁠https://music.amazon.de/podcasts/ee3580cb-61c5-4aa1-9ad4-1204014078e7/understandable⁠  ► Reach Out To Me :) E-Mail: info@understandable-podcast.com ► About: Insight through understanding yourself: Our mission is to make topics regarding your personality understandable and relatable. We aim to help you to gain insight into your true personality to feel more inner peace and love. ► Disclaimer: None of the contents are therapeutic or medical recommendations. The contents are not to be understood as therapeutic-medical instructions and are neither intended as professional health advice nor as education. See the content as a starting point for self-advocating. 

Rogier van Bemmel in gesprek met hoogleraar in de psychiatrie Jim van Os, over de geestelijke gezondheidszorg in Nederland, de beperkingen van de DSM-5 en zijn pleidooi voor een nieuwe psychiatrie van samenwerking. Bronnen en links bij deze uitzending: DSM: Diagnostic and Statistical Manual of Mental Disorders Jim van Os, 'De DSM-5 voorbij! Persoonlijke diagnostiek in een nieuwe ggz': https://www.bsl.nl/shop/de-dsm-5-voorbij-9789036820356 'We zijn God niet. Een pleidooi voor een nieuwe psychiatrie van samenwerking': https://www.lannoocampus.nl/nl/we-zijn-god-niet De website van herstelacademie PsychoseNet: https://www.psychosenet.nl/ De website van online hulpsite Proud2Bme: https://www.proud2bme.nl/ -- Onze eindejaarsactie is weer van start gegaan. Alle beetjes helpen ons om u ook in het komende jaar dagelijks van interessante gesprekken te kunnen blijven voorzien. Doneer op https://www.gofundme.com/dnw2023 of op NL61 RABO 0357 5828 61 t.n.v. Stichting De Nieuwe Wereld. Lid worden van ons Patronaat? Meld je hier aan: https://petjeaf.com/denieuwewereld Alvast bedankt.

Als je homo was, dan was je ziek. Althans, dat vonden psychiaters heel lang. Deze week is het precies 50 jaar geleden dat homoseksualiteit als ‘psychiatrische stoornis' werd geschrapt uit de DSM (Diagnostic and Statistical Manual of Mental Disorders), het handboek van de psychiaters. Wat ging daaraan vooraf? En wat waren de gevolgen van die behandeling voor de homoseksuelen die ze ondergingen? Dat vragen we aan Lars van Dee, psychiater en voorzitter van het platform ‘LHBT+ en psychiatrie'. En aan Henk Brouwer, die in de jaren '60 vanwege zijn homoseksualiteit naar de psychiater werd gestuurd.

Voedselverslaving, suikerverslaving of verslaafd aan cafeïne. Is het overdreven om suiker en cafeïne als drugs te zien of voldoet het inderdaad aan de DSM criteria voor verslaving? In deze aflevering ga ik in gesprek met Romy Thumann, diëtist en ketogeen therapeut bij The Nourishing State. Romy is gespecialiseerd in voedselverslavingen en begeleidt mensen hierbij. De volgende onderwerpen komen aan bod: Probleem: voedselverslaving. Waaraan merken we dit? Wanneer is iets een verslaving? 11 criteria volgens DSM (Diagnostic and Statistical Manual of Mental Disorders) Welke additieven/toevoegingen zijn verslavend? Suikerverslaving: effect en hoe ga je hiermee om Cafeïne/ koffieverslaving: effect en hoe ga je hiermee om

In this episode, the hosts begin our new miniseries on social anxiety disorder. They provide an overview of the topic, discuss the cultural perspective of social anxiety disorder, and talk about their experiences with people who struggle with social anxiety. They also briefly touch on the DSM (Diagnostic and Statistical Manual of Mental Disorders) and its role in diagnosing mental health conditions. The hosts emphasize the importance of understanding social anxiety disorder through a biblical lens and plan to explore the topic further in future episodes.Episode Transcript

Dr. Baker is a nationally recognized expert in parental alienation, and parent-child relationships, especially children of divorce, and emotional abuse of children. She has a Ph.D. in developmental psychology from Teachers College of Columbia University. She is the author or co-author of 10 books and over 120 academic articles on topics related to children's well-being. In this episode, we discuss the 17 primary strategies of parental alienation, 5-factor Baker model, the research behind it, how the court system addresses parental alienation and why its not listed in the DSM (Diagnostic and Statistical Manual).Amy offers many services including telephone coaching for targeted parents, telephone clinical case consultations, and in-person and virtual trainings for legal and mental health professionals. Dr. Baker can be reached at: Dr. AmyJLBaker@gmail.com and (201) 321-9874What is parental alienation?Parental alienation is the term to describe the overall problem of children being encouraged by one parent - the favored parent -- to unjustly reject the other parent -- the targeted parent. The specific behaviors that they engage in are referred to as parental alienation strategies. Parental alienation often but not always occurs in divorced families.Allow us to introduce your hosts, Mick Smith and Kindra Riber, who are fervently fighting to put an end to the excruciating pain caused by divorce, parental alienation, custody battles, and the disintegration of families. Their mission is to equip you with the necessary tools to heal and recover from the aftermath of family trauma and drama.If you find yourself entangled in a high-conflict divorce or experiencing the heart-wrenching alienation from your children, we encourage you to share your story with us. Reach out to us at theaftermathhealing@gmail.com and let your voice be heard.This has been a Mediacasters Production.

La cinquième version du DSM (Diagnostic and Statistical Manual of Mental Disorders) identifie comme dépression tout tableau associant plusieurs symptômes pendant au moins deux semaines, parmi lesquels l'humeur dépressive et/ou la perte de plaisir et d'intérêt. Si la sexualité n'est pas directement abordée dans le manuel, elle reste quasiment toujours impactée par la dépression et son évolution, soit directement, soit indirectement par le biais des traitements.Libido et dépression : un lien physiologique clairD'après une étude publiée dans le Journal of Clinical Psychiatry en 2002, jusqu'à 70% des personnes qui souffrent de dépression majeure font également état d'une baisse de libido. La dépression est associée à une diminution des niveaux de dopamine et de sérotonine, des neurotransmetteurs impliqués dans la gestion de l'humeur. Quand on sait que ces composés influencent le désir sexuel, on comprend que le rapport entre la dépression et la baisse de libido est étroit d'un point de vue physiologique.L'anhédonie sexuelle, c'est-à-dire la difficulté à ressentir du plaisir ou de la satisfaction lors des rapports, est aussi liée à la perturbation hormonale que la dépression induit au niveau de la testostérone et des œstrogènes. En outre, les changements de régulation de la récompense et du plaisir en phase dépressive favorisent l'insatisfaction sexuelle. D'après une étude menée par la Harvard Medical School en 2012, les personnes dépressives ont deux fois plus de risques de développer une anhédonie sexuelle.Les conséquences physiques de la dépression sur la fonction sexuelleAu-delà d'une modification du désir, la dépression induit aussi un changement dans la qualité de fonctionnement des organes sexuels. Les hommes souffrent alors de dysfonction érectile, d'éjaculation précoce ou retardée, tandis que les femmes connaissent une baisse de lubrification vaginale et une augmentation de la douleur lors des rapports, nommée dyspareunie.Lorsque la dépression s'accompagne d'une perte importante de poids ou, au contraire, d'une prise rapide de poids, elle modifie considérablement l'équilibre hormonal et la conscience que la personne a de son corps. Celle-ci peut se sentir moins désirable, étrangère à ses sensations ou à son propre corps.Les traitements anti-dépresseurs et leur impact sur la sexualitéIl ne faut pas oublier de mentionner que les médicaments utilisés pour traiter la dépression présentent un impact considérable sur la libido et la fonction sexuelle. Ainsi, les inhibiteurs de la recapture de la sérotonine peuvent faire baisser la libido, provoquer des difficultés d'érection, des problèmes pour connaitre un orgasme ou une baisse générale du plaisir sexuel. Le rapport bénéfice/risque du médicament doit alors être évalué par le patient et le médecin afin d'établir l'intérêt ou non de poursuivre le traitement. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

La cinquième version du DSM (Diagnostic and Statistical Manual of Mental Disorders) identifie comme dépression tout tableau associant plusieurs symptômes pendant au moins deux semaines, parmi lesquels l'humeur dépressive et/ou la perte de plaisir et d'intérêt. Si la sexualité n'est pas directement abordée dans le manuel, elle reste quasiment toujours impactée par la dépression et son évolution, soit directement, soit indirectement par le biais des traitements. Libido et dépression : un lien physiologique clair D'après une étude publiée dans le Journal of Clinical Psychiatry en 2002, jusqu'à 70% des personnes qui souffrent de dépression majeure font également état d'une baisse de libido. La dépression est associée à une diminution des niveaux de dopamine et de sérotonine, des neurotransmetteurs impliqués dans la gestion de l'humeur. Quand on sait que ces composés influencent le désir sexuel, on comprend que le rapport entre la dépression et la baisse de libido est étroit d'un point de vue physiologique. L'anhédonie sexuelle, c'est-à-dire la difficulté à ressentir du plaisir ou de la satisfaction lors des rapports, est aussi liée à la perturbation hormonale que la dépression induit au niveau de la testostérone et des œstrogènes. En outre, les changements de régulation de la récompense et du plaisir en phase dépressive favorisent l'insatisfaction sexuelle. D'après une étude menée par la Harvard Medical School en 2012, les personnes dépressives ont deux fois plus de risques de développer une anhédonie sexuelle. Les conséquences physiques de la dépression sur la fonction sexuelle Au-delà d'une modification du désir, la dépression induit aussi un changement dans la qualité de fonctionnement des organes sexuels. Les hommes souffrent alors de dysfonction érectile, d'éjaculation précoce ou retardée, tandis que les femmes connaissent une baisse de lubrification vaginale et une augmentation de la douleur lors des rapports, nommée dyspareunie. Lorsque la dépression s'accompagne d'une perte importante de poids ou, au contraire, d'une prise rapide de poids, elle modifie considérablement l'équilibre hormonal et la conscience que la personne a de son corps. Celle-ci peut se sentir moins désirable, étrangère à ses sensations ou à son propre corps. Les traitements anti-dépresseurs et leur impact sur la sexualité Il ne faut pas oublier de mentionner que les médicaments utilisés pour traiter la dépression présentent un impact considérable sur la libido et la fonction sexuelle. Ainsi, les inhibiteurs de la recapture de la sérotonine peuvent faire baisser la libido, provoquer des difficultés d'érection, des problèmes pour connaitre un orgasme ou une baisse générale du plaisir sexuel. Le rapport bénéfice/risque du médicament doit alors être évalué par le patient et le médecin afin d'établir l'intérêt ou non de poursuivre le traitement. Learn more about your ad choices. Visit megaphone.fm/adchoices

Why are there so many stigmas towards the LGBTQ+ community? I'm sure we've all heard the following statements... “Homosexuality is a choice” “You can't be queer and religious” “All bisexuals are promiscuous” And many more! Before the 1970s, most stereotypes about the LGBTQ+ community were extremely negative, doctors believed if you were gay, you suffered from a mental disorder. In 1973, the American Psychiatric Association removed homosexuality as a mental disorder, but then replaced it with "sexual orientation disturbance." Then in 1987, the (DSM) Diagnostic and Statistical Manual of Mental Disorders removed homosexuality from their list. We also dive into stigmas regarding HIV. For as long as HIV has existed in the public eye, it has been associated with the LGBTQ+ community. We are excited to share that we are partnering up with The Black Aids Institute.  The Black Aids institute is dedicated to ending the HIV/AIDS epidemic in the Black community. Some of you may be thinking to yourself “HIV doesn't affect me because I'm a lesbian who dates women only”. However, today there are more than 1.1 million people living with HIV in the U.S and 23% of them are women. HIV affects women of color, especially black women. This is an important reminder to get tested and to get that HIV vaccine once it comes out, we're manifesting it will be very soon!  Family Meeting Q&A “I can't get over my ex-girlfriend”. “How long would you be willing to wait for a marriage proposal before calling it quits?” FOLLOW LES CHAT ON SOCIAL MEDIA/PATREON:  IG: https://www.instagram.com/les.chatpodcast/   TIKTOK: https://www.tiktok.com/@les.chatpodcast?is_from_webapp=1&sender_device=pc  YOUTUBE: https://www.youtube.com/@leschatpodcast/  PATREON: https://www.patreon.com/leschatpod  Link tree: https://linktr.ee/leschat  Gender Neutral Boxers: Get 10% off with our code: LES10 https://www.luckyskivvies.com/ --- Support this podcast: https://podcasters.spotify.com/pod/show/leschatpodcast/support

In this revealing and insightful interview, host Damon Frank sits down with holistic psychotherapist and certified internal family system practitioner Dawn Elliott Kendall to discuss her journey with food addiction and recovery. They delve into the emotional and psychological aspects of food addiction, its unique challenges, and the significance of connection and support in overcoming this struggle.Join us as we explore how even high achievers can be affected by addiction and why acknowledging and addressing the problem is the crucial first step toward healing. If you or someone you know is struggling with food addiction, this video provides valuable insights and resources to help navigate the journey to recovery.

Recent research indicates that many autistic people might have co-occurring substance use disorder. Let's talk about what this entails and reasons for autistic folks turning to substances in the first place. Topics discussed also include:Substance use disorder according to the DSM (Diagnostic and Statistical Manual of Mental Disorders)How those with ADHD + autism may be at an even greater risk for developing substance use disorder (SUD)The problem with current SUD treatment optionsOther risk factors unique to autistic individuals that put them at greater risk for developing substance misuse and/or substance use disorderIf you'd like to know more about topics discussed in this episode, check out: "Autism and Co-occurring Substance Use" by Espen Ajo Arnevik and Sissel Berge Helverschou"Systematic Review of Risk and Protective Factors Associated With Substance Use and Abuse in Individuals With Autism" by Madelaine Ressel et al.Episode intro and outro music: "What Goes Around Comes Back Around" by NIGHTCAP Support the showThe Other Autism theme music: "Everything Feels New" by Evgeny Bardyuzha. All episodes written and produced by Kristen Hovet.If you would like to submit a question to possibly be answered in a future episode, please email kristen.hovet@gmail.comBecome a supporter of the show for as little as $3 a month!The Other Autism podcast on InstagramThe Other Autism podcast on FacebookBuy me a coffee!For transcripts, go to The Other Autism on Buzzsprout, click on an episode and then click on "Transcript" to the right of "Show Notes".

On this Hacks & Wonks midweek show, Crystal has a robust conversation with Damon Petrich about his research at the School of Criminal Justice at the University of Cincinnati. As lead author of the seminal work “Custodial Sanctions and Reoffending: A Meta-Analytic Review,” Damon performed an extensive analysis of 116 research studies looking at the effect of incarceration on reoffending. The review's finding that the oft-used policy of imprisonment does not reduce the likelihood of recidivism sparks a discussion about how the United States ended up as the world leader in mass incarceration and the disconnect between conventional assumptions about what prisons provide versus reality. Noting that the carceral system does a poor job of rehabilitation - while eating up budgets across the country and exacting significant societal costs - Damon and Crystal talk about how to design and evaluate programs that do work to deliver greater public safety for everyone. As always, a full text transcript of the show is available below and at officialhacksandwonks.com. Find the host, Crystal, on Twitter at @finchfrii and reach Damon for more information about his research at dpetrich@luc.edu   Resources  “Custodial Sanctions and Reoffending: A Meta-Analytic Review” by Damon M. Petrich, Travis C. Pratt, Cheryl Lero Jonson, and Francis T. Cullen for Crime and Justice   Scott Hechinger Twitter thread   “Mass Incarceration: The Whole Pie 2022” by Wendy Sawyer and Peter Wagner from the Prison Policy Initiative   “Risk-need-responsivity model for offender assessment and rehabilitation” by James Bonta and D. A. Andrews for Public Safety Canada   “Let's Take a Hard Look at Who Is in Jail and Why We Put Them There” by Alea Carr for the ACLU-WA blog   Book - “Great American City: Chicago and the Enduring Neighborhood Effect” by Robert J. Sampson   Byrne Criminal Justice Innovation Program - “Police Legitimacy and Legal Cynicism: Why They Matter and How to Measure in Your Community”    “Polls Show People Favor Rehabilitation over Incarceration” by Matt Clarke for Prison Legal News   Transcript [00:00:00] Crystal Fincher: Welcome to Hacks & Wonks. I'm Crystal Fincher, and I'm a political consultant and your host. On this show, we talk with policy wonks and political hacks to gather insight into local politics and policy in Washington state through the lens of those doing the work with behind-the-scenes perspectives on what's happening, why it's happening, and what you can do about it. Full transcripts and resources referenced in the show are always available at officialhacksandwonks.com and in our episode notes. Well, I am excited to welcome Damon Petrich, who's a doctoral associate in the School of Criminal Justice at University of Cincinnati and incoming assistant professor at Loyola University Chicago. He was the lead author of a recent article, "Custodial Sanctions and Reoffending: A Meta-Analytic Review," along with Travis Pratt, Cheryl Lero Johnson, Francis T. Cullen. Damon's research focuses on the effectiveness of corrections and rehabilitation programs, desistance from crime, and the impact of community violence on youth development. Thank you so much for joining us, Damon. [00:01:13] Damon Petrich: Thank you very much for having me on, Crystal. I'm excited to talk a little bit about my work and the implications of that and all that, so thanks again. [00:01:20] Crystal Fincher: I'm very excited to talk about this and it's extremely timely - has been for a while. We have conversations almost every day in the public sphere having to do with public safety - this is such a major component of it. And so I'm hoping as we have this conversation, it'll help us to better assess what the costs and benefits are of custodial sanctions and incarceration, and alternatives to that - to have a conversation that kind of orients us more towards public safety. Sometimes we're so concerned with metrics around police and how many they are, and what the length of a sentence should be. And sometimes we focus on things that take us off of the overall goal of keeping us all safer and reducing the likelihood that each of us are victimized and to hopefully prevent people from becoming victims of crime. And just to have accurate conversations about how we invest our public resources - what we're actually getting from them, and then how to evaluate as we go along - what we should be tracking and measuring and incentivizing. As so many people talk about taking data-driven approaches and create all these dashboards - that we're really doing it from an informed perspective. So just to start out - what actually were you studying and what were you seeking to find out? [00:02:47] Damon Petrich: Yeah, so the main purpose of our meta-analysis, which I can explain exactly what that is later on if you have questions, but the main purpose was to understand what happens when you take one group of offenders and you sentence them to something custodial like prison or jail, and then you sentence another group of similar offenders to something non-custodial like probation. How do those two groups differ in terms of whether they reoffend? So does prison actually deter recidivism, or does it make people more likely to commit crime afterwards? So that's sort of what we were looking at and so we considered all of the available research on that, in this review. [00:03:29] Crystal Fincher: Got it. So right now we have gone down the path of mass incarceration - that is the default punishment that we, as society, have looked to for crime. Hey - sentence them and many times it's, Hey, they're going to jail. Sometimes they get out of jail and they have supervision that continues, but jail is really focused, where we focus a lot of our effort and where we put people and hope that that'll straighten them out and they come out and everything is fine. How did we get here and where are we in terms of how we're approaching incarceration in our society, in our country? [00:04:11] Damon Petrich: Yeah, so there is a lot of public uproar around a lot of issues, like race issues, and there was crime spikes and concerns over social welfare - and there's all this confluence of issues in the '60s and early '70s. And we decided to - as a country, not everyone, but politicians decided that we should tackle the crime problem by A) incarcerating more people, and then B) once they get there, keep them there for longer. So we enacted things like mandatory minimum sentences, where the judge really has no discretion over what happens - the person gets automatically a sentence of incarceration if they've committed a certain type of crime. You had habitual offender laws where if you're - like California's three strikes policy - where if you have two prior felonies and you get a third, no matter what it is, you're going to jail for life. Michigan had the "650 Lifer Law," where if you get caught with 650 grams of heroin or cocaine, you're automatically going to prison for life. And then we got rid of parole and stuff like that in a lot of states. So all these things lead to more people going to jail and then for longer, and those laws came to be in the '70s and '80s. And over that time, our incarceration rate ballooned up by about 700%, so by the early 2000s, we were at over 2 million people incarcerated and another 7-8 million people on probation or parole. So it's a pretty big expansion - the United States has 5% of the world's population and a quarter, or 25%, of the prisoners, so it's a little ridiculous. The crime rate here isn't nearly as high, or nearly high enough to justify that huge disparity. So yeah, it's a whole confluence of factors led us to be the world leader in incarceration. [00:06:14] Crystal Fincher: And what attitudes or what justifications are the people who have the power to enact these policies and continue these policies - how are they justifying them? [00:06:25] Damon Petrich: So there's a few reasons why you might want to incarcerate somebody. One is just because you want to punish them or get revenge on them, so that's more of a moral reason. But the main focus of politicians were twofold - one was incapacitation, so that one means that because you're keeping somebody locked up in a cage, obviously they can't be out in the community committing crimes. So the thought is that you're going to reduce crime that way. The research on that is a little squishy even now, and I can talk a little bit more about that later if you want. But the other reason, and the one that we focused on in our review, was that prison deters people from going back to crime after they get out. So the idea there is that prison sucks - you go in there, you're cut off from your job, from your family, from your friends, or from just having hobbies or things to do. And you're not going to want to go back, so when you get out of prison - you think real hard, and you think how much prison sucks, and you decide not to go back to crime. That's the thinking behind that deterrence hypothesis anyway. So those two - incapacitation and deterrence - were the main drivers of those increase in laws and stuff during the '70s, '80s, and '90s, but there really wasn't any evidence for either of them - in the '70s and '80s in particular. So most of the research evaluating whether prison actually does deter recidivism has popped up over the last 25 years or so. [00:08:05] Crystal Fincher: And as you took a look at it - all of the studies that have popped up over the past 25 years had varying degrees of rigor and scientific validity. But as that body of research grew, people began to get a better idea of whether incarceration actually does reduce someone's likelihood of reoffending. How big was that body of work, in terms of studies, and what were you able to look at? [00:08:40] Damon Petrich: So in our particular review, we looked at 116 studies, which is a pretty sizable number. Most people - when you read through an article and a literature review might have 10 studies or something that they just narratively go through, but we looked at 116. And then within those 116 studies, there were 981 statistical models. So 901 different comparisons - or 981 different comparisons - of what happens to custodial versus non-custodial groups. So we looked at a pretty big chunk of literature. [00:09:20] Crystal Fincher: And in that, in the reliance of - that's a really big number - and I think, people now are maybe more familiar, just from a layperson's perspective, of just how big that number is. As we've seen throughout this pandemic that we're in the middle of, studies come out - people are looking at one study, and wow - study number two comes out and we're feeling really good about it. And man, we get to five studies and people are like, okay, we know what's going on. To get beyond a hundred is just a real comprehensive body of study and analysis. What were you able to determine from that? [00:10:05] Damon Petrich: So I should probably explain upfront what a meta-analysis is and why it's useful. So like you were just saying - like in the COVID pandemic, for example - one study will come out and it'll say, oh, Ivermectin reduces symptomatic COVID cases by X percent. And then the next study will come out and say, Ivermectin makes people way worse. So any individual study can be kind of misleading. A good analogy for what a meta-analysis does would be to look at baseball, for example. So let's say you're interested in some rookie player that's just come out, he's just joined Major League Baseball and you go to his - you want to know how good this player actually is? You've never seen him play, you've only heard rumors. So you go out to his first game, he gets up to bat four times and he gets no hits. So you walk away from that game thinking, wow, this player is terrible, the team wasted all their money recruiting and paying this guy's salary. But that could have just been an off game for many reasons - it's his debut game so maybe there's just first-game nerves, maybe the weather was bad, maybe he was having personal problems in his life, or he had a little bit of an injury. So there's a number of reasons why looking at his performance from that one game is not going to be representative of who he is as a player. Ideally, you'd want to look at all the games over a season where he might go up to bat 250 times. And over those 250 times, he gets 80 hits, which is a pretty good batting average - it's over .300. So with that amount of data, you could come to a more solid conclusion of whether he's actually a good player or not. And with that amount of data, you could also look at what we call moderating characteristics. So you could look at, for example, whether he plays better when it's an away game or in a home game, whether it's early or late season - you could look at all these sorts of things. So this is essentially what we're doing with research as well, in a meta-analysis. So if you look at studies on incarceration - one might show increases in recidivism after people go to prison, the next might show decreases, and the next might show that probationers and prisoners reoffend at about the same rates. So just like in the baseball analogy, in a meta-analysis, we're looking at all of the available research. We're combining it together and determining A) what the sort of overall or average effect of incarceration is, and then B) whether these moderating characteristics actually matter. So in other words, is the effect of incarceration pretty much the same for males as it is for females, or for juveniles as adults, or when the research design is really good versus when it's not so great. So that's basically what we did in this meta-analysis is again - looked at 116 studies and from those 981 statistical estimates. [00:13:13] Crystal Fincher: Very helpful. Totally makes sense with the baseball analogy, and I especially appreciate breaking down with all the statistical models and not just kind of thumbs up, thumbs down - the binary - it either increases or reduces the likelihood of recidivism. But under what conditions are - might it be more likely, less likely that someone does? What are some of those influencing effects on what happens? And so you were just talking about the justification that people used going into this, and now that we have data coming out - does it turn out that people go into prison or are incarcerated in jail, they think - wow, this is horrible. Some in society are like the more uncomfortable we make it in jail, the better we want to make sure it's a place that they never would want to come back to - that it's so scary and such a bad experience that they are just scared straight for the rest of their lives. Does it actually turn out to be that way? Do they take a rational look at - this was my experience, I don't want to go back again, therefore I will not do any of the things that I did going in. [00:14:28] Damon Petrich: I would not say that's the conclusion - no. So again, based on the 116 studies that we looked at, which is again a lot, people who are sentenced to incarceration - so jail, prison - they commit crime, they reoffend at about the same rates as if you'd sentence those same people to probation. So in other words, they're not being deterred by being sent to prison. These effects are the same for both males and females. So in other words, prison doesn't reduce reoffending for one group versus the other. It's the same whether we look at adults versus juveniles, it's the same regardless of what type of recidivism we're interested in - rearrests or convictions. It's pretty much the same across the board. There's some slight variations in research designs, but even within those, prison either has no effect or it slightly increases recidivism. We don't find any conditions under which prison is reducing reoffending or deterring these people from going back to those lives. [00:15:35] Crystal Fincher: So from a societal perspective, a lot of people kind of make the assumption that, Hey, we arrest and we incarcerate someone - whew, our streets are safer. They get out, and now they can choose to reintegrate themselves into society hopefully - they do and we're all safer because of it. But it looks like impressions that some people may have that, Hey, we're letting someone off easy. And suggestions - there's so much media coverage around this - and suggestions that because we're letting people off easy, that we're making it easier for them to reoffend, or they don't feel sufficiently punished enough and so that becomes an incentive to reoffend. Does that seem like it tracks with what the studies have shown? [00:16:33] Damon Petrich: Not really - so there's some studies that actually ask prisoners and offenders whether they'd prefer going to prison or probation. And a lot of them will say, oh, I'd rather do a year in prison than spend two or three years on probation. So it's not like they view probation as just being super easy. And they're not saying this because they received time off their sentence for being in the study or anything like that. Probation's not easy either - and you have to also think that while these people are on probation, they're able to stay in close touch with their family, they're able to maintain connections with work or find work, they're able to participate in the community, they can pay taxes - that I know a lot of people who are pro-prison love. So there's all sorts of reasons why - beyond just them reoffending at the same rates as if they'd gone to prison - there's a lot of reasons why we might want to keep these people in the community. And it's not like we're saying, let everybody out of prison - so the nature of this research - you want to compare apples to apples. So in this research, comparing prisoners to probationers - these have to be people who are getting - they could either legitimately get a sentence of jail or probation, or prison or probation. So these are going to be first-time offenders, people who are relatively low-level - they've committed low-level crimes and all that. So we're not saying - there's not going to be a situation where a murderer just gets probation - that sort of thing. So I know that might be a concern of some people - they think that's a natural argument of this analysis, but it's really not. [00:18:24] Crystal Fincher: Well, and to your point, we're really talking - if we're looking at all of the crime that gets people sentenced to prison time, a very small percentage of that is murder. A very small percentage of it is on that kind of scale - you can wind up in jail or prison for a wide variety of offenses - many of them, people perceive as relatively minor or that people might be surprised can land you in prison. Or if someone has committed a number of minor offenses, that can stack up - to your point in other situations - and increase the length of detention or the severity of the consequences. As we're looking through this and the conversation of, okay, so, we sentence them, we let them out - it's not looking like there's a difference between jail or community supervisions, things like probation - what is it about jail that is harmful or that is not helpful? What is it about the structure of our current system that doesn't improve recidivism outcomes for people? [00:19:42] Damon Petrich: Probably the main one is the rehabilitation is not the greatest. So just as an example, substance abuse is a very strong predictor whether people are going to reoffend, unsurprisingly. About 50% of prisoners at the state and federal level in The States meet the DSM [Diagnostic and Statistical Manual of Mental Disorders] criteria for having a substance use abuse disorder - so they meet the clinical criteria for substance abuse disorder. So half of them, and then more than that just use substances, but they don't meet the criteria for a disorder. But of that 50% who has a substance abuse disorder, only about 20% of those actually receives treatment for it while they're incarcerated. So, you're not dealing with a root cause of reoffending while they're in prison - so you're not deterring them, but you're also not rehabilitating them - so you're really not doing anything. And then in the rare cases where these people are provided with rehabilitation or reentry programming, it's often not based on any sort of evidence-based model of how you actually change people. So there's a lot of psychological and criminology theory and research on how you actually elicit behavioral change, and these programs really aren't in line with any of that. And I could give examples if you wanted, but - [00:21:17] Crystal Fincher: Sure. I think that's helpful, 'cause I think a lot of people do assume, and sometimes it's been controversial - wow, look at how much they're coddling these prisoners - they have these educational programs, and they get all this drug treatment for free, and if they don't come out fixed then it's their own fault because they have access to all of these treatment resources in prison. Is that the case? [00:21:43] Damon Petrich: No, I wouldn't say so - first of all, they don't have access, a lot of them, to any programs. And then, like I said, the programs that they do get really aren't that effective. So the big one that everybody loves to argue for is providing former inmates with jobs. If you look at any federal funding for program development, like the Second Chance Act or the First Step Act - I think that was one under Trump - and then under Bush, there was a Serious [and] Violent Offenders Reentry Initiative - pretty much all of these federal bills will be heavily focused on just providing offenders with jobs. And almost all of the evaluations of these programs show that they don't reduce reoffending. And it's not really that hard - again, if you go back to the literature on behavioral change and, criminology literature - it's not really that hard to understand why just providing a job isn't going to reduce or lead somebody away from a life of crime. A lot of these people have spotty work histories where they've never had a job at all, they believe and know that it's easier to gain money by doing illicit work than it is legal work, they have things like low self-control so they're very impulsive, they don't know how to take criticism or being told what to do by a boss. They live in neighborhoods with very poor opportunities for good jobs and education, and maybe there's a mindset around there that illegal work or whatever is just a better way to go - that's sort of ingrained. So there's a lot of different reasons why just handing somebody a job isn't going to lead them away from crime, 'cause they have all these other things that need to be dealt with first. So ideally, a rehabilitation program that's comprehensive would deal with all of those other background factors and then provide them with a job. Because if you make them less impulsive, better able to resist the influence of their antisocial friends, and get this thought out of their head that other people are being hostile towards them when they're really not - all these sorts of cognitive and behavioral biases that they have - if you deal with all of those things and then you give them a job, they're more likely to actually latch onto that job as something worthwhile doing. And then they're going to go on to get out of a life of crime. But if you just give them a job and you haven't dealt with any of those issues, you can't really expect that to work. And that is the model that we currently do - is something that we don't really expect to work that well. [00:24:28] Crystal Fincher: Yeah, that's - it's really interesting and I don't know that a lot of people actually know that, Hey, giving someone a job isn't sufficient - which is why I think it's so important to talk about studies like this, because some of what has become conventional wisdom, really is not accurate or reflects what has been studied and discovered. And I guess in that vein, what are the factors - you just talked about a few - but what does increase someone's likelihood of reoffending or recidivism, and what reduces it? [00:25:08] Damon Petrich: So those are probably two ends of the same, or two sides of the same coin, but this is pretty well known in criminology - a model called the risk-need-responsivity [RNR] model was developed by a couple of fellow Canadians, named James Bonta and Don Andrews, along with some of their colleagues in the '80s and '90s. And they, through again, other meta-analyses just like we did, found certain categories of characteristics of people who are more likely to reoffend. So you have things like having antisocial peers - so that one's pretty obvious - if you have a bunch of friends that are involved in crime, it's going to be pretty hard for you to get out of that life because you're surrounded by those people. Same with family members. If you have what are called criminal thinking patterns - so again, you might have what's called a hostile attribution bias, things like that, where somebody says something a little bit negative to you and you take that as a huge insult and you retaliate with anger and aggression - things like that. Or being impulsive - so you're again quick to anger, you're swayed by small little enticements in the environment and that sort of thing - so you're easily swayed one way or the other. Things like that are strong predictors of reoffending. Substance abuse - it's what I mentioned earlier. If you don't really have any sort of proactive leisure activities, like hobbies and stuff like that. So there's a bunch of well-known things that we know are strongly associated with recidivism, and a rehabilitation program should ideally deal with them. Now this model that Andrews and Bonta and all these other people came up with - this RNR risk-need-responsivity model - the risk part says that we should give people a risk assessment when they're entering prison or leaving prison and determine what level of risk are they from reoffending. And we assess these different criteria, like criminal thinking patterns and antisocial friends and substance abuse. So we determine what those factors are and then we design them a treatment program that actually deals with those factors at the individual level. So we're not just giving a blanket rehabilitation program to everybody, and you're providing the most amount of care to the people who most need it or who are the most likely to re-offend. And then once we've done all that, we need to make sure that we're addressing these problems in some sort of a format that we know actually works. The most well-known one, but not as often used, the most well-known within the sort of psychologist and criminological literature is cognitive behavioral therapy [CBT]. So this is pretty popular for dealing with depression and all sorts of eating disorders and substance abuse problems in non-offender populations. Well, those programs also work in offender populations and they work pretty well. So the research shows - again meta-analyses - that when you deal with all these three factors - risk, need, and responsivity - you can reduce reoffending rates by about 26%. So it's a pretty sizeable amount - it's much greater than you're getting by just sentencing people to prison without doing anything. [00:28:42] Crystal Fincher: Absolutely, and I think you cover in your paper - those things are absolutely true. And you just talked about several administrations' attempts to implement programming and resources to try and help people get jobs, potentially - hey, there's even a CBT treatment, but if that treatment has twice as many people as are recommended being in a session and occurs over half the time that it's supposed to, you really are sabotaging the entire process or really setting it up for failure. And it just seems to be an expensive exercise that we aren't really getting anything out of. Does that seem to be consistent with how you've seen the attempts at introducing this programming within prisons and jails? [00:29:40] Damon Petrich: Yeah, for sure - this is a pretty common finding too - so it's not just about preaching that you're going to do these things. You actually have to implement them well. So just like you said, there's a number of studies that show this - so you've designed some really great program that deals with all of these risk factors that lead people back into reoffending, you give it to them in a cognitive behavioral setting. So all seems good on paper, but in practice, like you said - one of the famous studies there - can't remember the names of the authors offhand right now - but one of the famous studies there showed that they're providing it to people in groups of 30, as opposed to 15, and they're delivering it in a really short amount of time. And they're not maybe giving it to the highest-risk people - so they're just mixing random people in there at varying levels of risk. So when you do all these sorts of things - you implement the program poorly - you can't really expect it to work. And this is often the case - is the government pays people to come up with these great programs, and then not enough funding is provided to actually make sure that they're implemented and evaluated well. So the amount of funding that actually goes into that - developing the programs to begin with - is small, but when you do do that, you're not making sure that you're actually implementing things well. So it's just sort of shooting yourself in the foot, and probably making people come to the conclusion that these things don't work - when they do work, if you just implement them well. [00:31:17] Crystal Fincher: Yeah, and there's also a lot of rhetoric - and you discuss this - there's a lot of rhetoric coming from the government, even coming from leadership within the Bureau of Prisons or leadership in our carceral system, saying we do want to rehabilitate people. We are trying to implement programming that does this. You see - we have these educational opportunities and we are doing evaluations of people. And it may be happening while they're understaffed or other challenges, but one of the biggest, I guess, red flags is that none of the evaluation of their programs and none of the incentives that arise are in any way tied to what is the actual result of what happens. Are you actually succeeding on reducing someone's likelihood for reoffense? It does not seem like any compensation is tied to that, any kind of evaluation of positions or regular reporting - to say, is this program having its intended effect? And if not, what do we need to do to correct for that? Is that what you found? [00:32:33] Damon Petrich: I would say that's probably a pretty fair assessment. A lot of the programs that are implemented are never evaluated at all. And then the ones that are - it's usually once - there's one evaluation of those programs. And then, like you said, there doesn't really seem to be a lot of self-reflection - I don't know what other word you would use - but these programs don't really change on the basis of these evaluations. So, it's kind of disheartening to hear about, I guess. [00:33:14] Crystal Fincher: It feels very disheartening to live in the middle of - and one of the big things about this is that this - we have these conversations and we talk about these studies and we're saying, yeah, it actually - we're not doing anyone any favors right now when it comes to reducing recidivism. And having these conversations oftentimes detached from the cost associated with what we're paying for these. And my goodness are we paying to incarcerate people? It's not just, well, we do lock them up and we keep them away. Or we do a good job of keeping them in - they reoffend, they go back to jail. And lots of people are like, we did our job, they went back to jail - boom, everything is fine. But we are paying through the nose and out the ear for this - just here, we're in the state of Washington, and right now the state spends about $112 per day, or over $40,000 annually, to incarcerate one individual - that's the cost per inmate. In King County - the county that we're in - they spend $192 a day, or $70,000 annually, to incarcerate an individual. That is a huge amount of the tax dollars that we spend - these come out of our general fund, meaning that these are dollars that every service, everything that is not a dedicated source of revenue, is competing for. So when we talk about things and have conversations like, well, we don't have the budget for that and we don't have the money - that is related to how much of that money we're spending on other things. And my goodness, I would think that we want to get our money's worth for that level of expenditure. And it really appears that if we're saying the goal of jail is to get people on the straight and narrow path and becoming contributing members of society and all of the implications of that, it doesn't seem like we're getting our money's worth. And so, if those aren't the goals and if we just want to punish people, it's not like we're punishing people for free. We're punishing people at the cost of $70,000 per day [year], and at the cost of all the other services and infrastructure needs that we have. So it really seems like we're punishing ourselves as much, or more, as others - particularly if we're bringing people back into society that are likely to reoffend in one way or another. And so if our goal is to keep our community safe and that is the North Star, it looks like we need to realign our processes and our expenditure of resources. I guess my question to you, after all that, is - how should we be moving forward? What should we be looking to do? What is shown to work? [00:36:24] Damon Petrich: Well, I would say - yeah, $70,000 a year as just a revenge cost per person seems like a lot. $80 billion in the country as a whole, for a revenge cost, seems like a pretty high price to pay, given we're not reducing reoffending. You could make the argument that these people aren't offending while they're in prison, but that's - there's other reasons why that might not be completely accurate, which I could talk about too, but - [00:36:59] Crystal Fincher: Well, I'm interested in that. Why might that not be accurate? [00:37:03] Damon Petrich: So, obviously the person - if you incarcerate a particular individual, obviously they can't be out in the community committing crimes. So that's obvious, but there's a number of reasons why that might not, en masse, actually reduce crime a whole lot. The research on it - this is a little bit squishy - in terms of whether incarcerating more people leads to lower crime rates, because one influences the other. But for example, if you look at illegal drug markets - a lot of the homicides in the United States and other violent crime that people are really concerned about, and it's plastered all over the media is - homicides, gang-related stuff. So if you take key gang members out and you put them in prison, what ends up happening is that there's competition in that market to take over that person's place, either within the gang or other gangs coming in. So what ends up happening oftentimes is a spike in violence. So that's one reason why just incapacitating, particularly high-crime individuals, might not actually lead to lower crime rates overall. Again, you're lowering crime for that one person, but you might be increasing crime on a more systemic level. Beyond that, these things have broader societal and community level impacts - incarcerating a lot of people. Again, research shows that when you're incarcerating a lot of people in a particular community - so there's a bunch of really good work by Robert Sampson - he has a book that came out a few years ago called Great American City. And he looked at these individual neighborhoods in Chicago over time, and what he finds is that in communities where there's a higher number of people incarcerated in a particular community, this ends up increasing what's called "legal cynicism." And this is done in some other work as well with David Kirk and Andrew Papachristos - but they show that this increases legal cynicism, which means people are skeptical of police helping them out, the police doing a good job. And what ends up happening after that - when people are more cynical of the legal system, they're less likely to report crimes to the police, they're less likely to cooperate with the police. So what ends up happening? You incarcerate more people and people in that community end up being less willing to cooperate with law enforcement. And this leads to sort of an endless cycle where things sort of get out of hand. So there's all these unintended and nonfinancial consequences of incarcerating a lot of people that could potentially end up leading to more crime. [00:40:03] Crystal Fincher: Well, and - speaking as a Black woman - obviously, looking at the impacts of mass incarceration in the Black community and in neighborhoods around the country - where it is almost like the community is responding to the actual outcome and that, Hey, this actually isn't making my community any better. I'm experiencing traumatic impacts from this - whether it's my relative went to prison or a sole breadwinner in the family and now we're thrown into poverty, or I'm in a situation where I don't have a parent who used to be there - who now is no longer there. Or causing instability and impacting the education that people get and the kind of job opportunity, watching someone who's come out have to struggle and be ostracized. And it looks like, Hey, this is just the first step on a long cycle of traumatic and undesirable events - and I don't want to participate in a system that is doing that. With that, as we look forward, and I think this is also related to conversations about just fundamental trust in our criminal legal system and relations with police and throughout the system. It's - if we think about how to turn that around - to me, seems related to thinking about the question of how do we get better outcomes for everyone? 'Cause it seems like right now where we're investing a lot in poor outcomes for people who were already, usually, in pretty poor spots leading to themselves being incarcerated, coming out and not necessarily improving, definitely not improving. And if anything, a chance that it gets a little bit worse. How do we change that entire outcome? And I know you're looking specifically in the incarceration space, but what should be, what could be done differently? Or do we just need a fundamental restructuring of the way we do this? [00:42:17] Damon Petrich: I don't know about a fundamental restructuring - I don't, I'm not great at that high-level thinking stuff, but what I do know is that - we're probably going to continue to incarcerate people. That's something that's done in every country and people seem to love here. So if we actually want to use prison for public safety - because 95% of inmates eventually get out - if we actually want to use it for public safety, then let's actually try wholeheartedly to rehabilitate them while they're in there. And again, there's a lot of theory and evidence-based principles on how we can do this, like the risk-need-responsivity model that I talked about earlier, cognitive behavioral therapy more broadly. If you use these types of things and continue to work on them and develop them over time, then yeah - prison might actually be helpful if people are going there and getting the help that they need. But that's not what's happening currently. So that's one level in incarceration terms - that's the area that I know best. So that's one way you could potentially alleviate some of this stuff is - if people are actually getting resources and stuff when they're in prison, and then when once they're reintegrating, they're not only going to reoffend less, but maybe they're going to contribute to their community more. They're going to be better able to connect with their family and stuff like that. So rather than being a hindrance, it could potentially be a help. Obviously, again, it's not ideal to remove people from their communities and their family and friends. And like I said earlier, if you have the option to sentence them to something community-based instead, I think that's the better route to go. But if you are going to send people to prison, which I think we're going to continue to do a lot of the time, then let's rehabilitate them while they're in there is the main point. And do so based on what actually works to do that. [00:44:23] Crystal Fincher: It's really the investment in the people who are there, and we're - I think up against a lot of societal attitudes and resistance where it just feels wrong to a number of people to be providing services and shifting that investment to things that are seemingly helpful for the inmate, because everything about how we've been conditioned to understand our prison system has been - the punishment is kind of the key, and they'll make rational decisions afterwards to avoid prison based on how bad the punishment is. When it comes to community supervision, things like probation, what are the differences there? If there are better outcomes from that, what accounts for the better outcomes when it comes to probation versus incarceration? [00:45:23] Damon Petrich: I wouldn't say the outcomes are better - they're just pretty much the same as they would be if they're sentenced to prison. So, probation costs less and then it also enables the people to be out in the community doing community things, like being with their friends and families and all that. I mean, you can't quantify, based on a recidivism percentage, what their family members and friends and employers are getting out of it. So that's something we can't really look at - or I guess you could, but something we don't often do - but so there's intangible things that you would get by keeping people in the community. Plus it doesn't lead to all that other stuff I talked about where people become cynical of the legal system and it leads to this cycle of whatever. [00:46:11] Crystal Fincher: Yeah, and so if we're were doing this programming in prison and helping people, I think your research shows it's extremely important to do both the structural, Hey, you need a place to live, you need to be able to pay your rent and your bills - so having a job, having housing, having healthcare, getting those very basic needs met is critical. But also addressing a number of the mental or behavioral health issues that are common among the incarcerated population - and dealing with that is as important. And basically those two things both need to happen hand-in-hand. How do we do a better job of that in our current system? [00:46:57] Damon Petrich: Well, first of all, I'd like to say that you're right there - I think maybe when I was talking earlier about employment, it might sound like giving people jobs is just a waste of time, but that's not the case. It needs - the two things need to be paired - you need to deal with the cognitive and behavioral problems in addition to giving them jobs and housing support and all that. In terms of how you actually go about doing that, there are examples in the literature of programs that do this, so there's examples out there. I think if you're a state or local or even federal correctional department and you're interested in doing this - implementing something that's evidence-based - or if you're just a concerned citizen that wants to rally your local officials to do that - go and talk to researchers like me, or people at universities that have criminology departments or criminal justice departments, because this knowledge is out there. It's widely available. You just have to go and seek it out. So at my university, for example, we have the University of Cincinnati Corrections Institute and under the guidance of Ed Latessa, he was - now passed - but he was, over the last 30 years, responsible for disseminating a lot of this evidence-based practices to some of the state and local criminal justice agencies. And they helped with implementation and evaluation in a lot of these places, so the help is out there. You just have to look for it a little bit. [00:48:38] Crystal Fincher: And another question I had - your analysis seemed to suggest that when we're talking about low-risk, medium, and high-risk offenders - or people who have done relatively minor crimes versus those who have done more serious crimes - that these interventions are particularly effective the more serious the offense or crime has been. And that perhaps even sometimes treating someone who is a really low-risk as if they're a high-risk, can worsen the outcomes for that person. Is that the case? [00:49:21] Damon Petrich: Yeah, that tends to be a finding in research - we're not exactly sure why, but providing a lot of really intensive services to people deemed to be low-risk can actually be harmful rather than helpful. We don't know based on research why, but there's a lot of pretty good hypotheses about why. So a low-risk offender is going to be somebody who's a first-timer who's committed some not-that-serious crime. So they probably have a job, they probably have pretty strong connections with their family and all that. So if you're taking them and you're putting them in a program where you have to be there 40 hours a week, they're probably going to get fired from their job, it's going to be harder to stay in contact with friends and families that are sort of tying you into a non-criminal life. And then you're probably going to be associating with all kinds of people who are high-risk, and maybe they're going to draw you towards, oh yeah, I could earn four grand going out tonight and stealing some laptops. There's a lot of reasons why just taking low-risk people and putting them in these programs is going to be harmful rather than helpful. [00:50:31] Crystal Fincher: And so with that in mind, and you talk about, Hey, if we're trying to influence local electeds - one of the interesting things about having a podcast and radio show that caters to extremely politically and civically inclined people is that we actually do have a number of policymakers and politicians who listen, and people who are enacting and in control of this policy. If you were to talk to them and give them advice about how to move forward, especially in the current environment that we find ourselves in, where over the past few years has been increasing awareness of some of the defecits of our system and pushes to change those. And also, as we have seen more recently, a real strong pushback from a lot of people who are invested in our current system saying, Hey, let's not change things too much. Maybe we need to jail more and for longer. And maybe we're just not doing enough incarceration, and that's the answer. In that kind of political environment, what would you tell people who are in charge of this policy, who may be facing pressure to keep going forward with the status quo, about how they should evaluate how they should move forward and the kinds of things that they should do? [00:52:07] Damon Petrich: I know a lot of these politicians get lobbied by correctional officer groups or whatever, and that's whatever, but ultimately you get voted in by voters. So, I'm not an expert on public opinion - I have other friends who are more into that kind of stuff, but I do know from talking with them and from reading that literature, that the public actually does support rehabilitation. So they have for a long time and it's shifted more towards being in support of rehabilitation over time. So right now, most Americans support providing rehabilitation programs to prisoners and offenders. So this is something that's going to please your constituency, people want this kind of thing. And it's not like you're going to be losing all kinds of jobs by getting rid of prison - there's going to be a need for skilled people who can provide these programs and probation officers and all these sorts of things. So it's not a net loss when you're getting rid of prisons. There's a lot of reasons to sentence people to community supervision and things like that - provide rehabilitation. There's public support for it, there's jobs involved, there's cost savings - big time, obviously - it's way cheaper to keep somebody out of prison than it is to keep them in prison. So there's a lot of different reasons why you would want to do that as a politician. [00:53:43] Crystal Fincher: I think that makes sense. Certainly it's a lot cheaper to keep someone out of prison versus in prison. I mean, we talked about the annual costs - in the state of Washington over $40,000, King County over $70,000 - comparing that to how much we invest in a student of $11,500 a year. If we focus more on investing in people, both inside and outside the system, it seems like we set ourselves up for a safer community, fewer people being victimized, and more people leading thriving, productive, tax-paying lives. And we're all happier than we are right now, I would think, I would hope - it seems like the research points in that direction. So I certainly appreciate you taking the time to speak with us about this. Is there anything else that you want to leave with us, in thinking about this study and your research? [00:54:55] Damon Petrich: I think we covered it pretty well. Just to circle back to something you just said - I know this might put me out of a job since I focus on what happens when people's lives go awry, but you really are better off to invest in early prevention programs and giving people a good start on life than trying to correct the program or the problem afterwards. So yeah - politicians spend some money on prevention programs. I know the good effects of that are a long way out, but they're actually good on a societal level. So I guess I would add that, even though it's not good for criminologists, maybe, to put themselves out of a job like that. [00:55:40] Crystal Fincher: Well, much appreciated, and thank you so much for having this conversation with us today. [00:55:45] Damon Petrich: Yeah, thank you very much for having me on. I'm glad that there are people out there interested in this stuff, so thanks again. [00:55:51] Crystal Fincher: I thank you all for listening to Hacks & Wonks on KVRU 105.7 FM. The producer of Hacks & Wonks is Lisl Stadler with assistance from Shannon Cheng. You can find me on Twitter @finchfrii, spelled F-I-N-C-H-F-R-I-I. Now you can follow Hacks & Wonks on iTunes, Spotify, or wherever else you get your podcasts - just type "Hacks and Wonks" into the search bar. Be sure to subscribe to get our Friday almost-live shows and our midweek show delivered to your podcast feed. If you like us, leave a review wherever you listen to Hacks & Wonks. You can also get a full transcript of this episode and links to the resources referenced in the show at officialhacksandwonks.com and in the episode notes. Thanks for tuning in - we'll talk to you next time.

Covert narcissism is narcissism from a unique angle. The internal characteristics are the same as an overt narcissist, but it plays out differently. Narcissism is not defined in the DSM (Diagnostic and Statistical Manual of Mental Disorders) as the loud and boisterous life of the party. It does not list traits of hitting, cheating, and yelling.  Rather, NPD (Narcissistic Personality Disorder) is defined as having a grandiose sense of self-importance, requiring excessive admiration, believing that they are special, having a lack of empathy, jealous of others, and arrogant. These traits and others are present in both overt and covert narcissists. How they show up differs. In this podcast, we explore these differences in order to raise awareness of covert narcissism.  This particular episode addresses the hyper-sensitivity of narcissists and how this displays for both overt and covert narcissists. Overt narcissists react with fear and use intimidation to control of their victim. Covert narcissists react with hurt and victimhood, using guilt and blame to control their victim.

What is depression? Is it sadness? Is it a lack of emuna? Come hear us hash it out! Clarification of terms: CBT: Cognitive Behavioral Therapy - A form of talk therapy where one can Gain an understanding of the issue: At the start of therapy, you'll discuss challenges you're dealing with, symptoms you've noticed and any concerns you have. If you've been diagnosed with a mental health condition, tell your therapist. This important first step will help you set goals for your therapy. Ask a series of questions: Depending on your situation, your therapist may ask you questions. You might discuss an incident in your past, fears or phobias, troubling behaviors or your thoughts and feelings. Together, you'll explore your answers so you can gain insight into how you respond to challenges in your life. Help you recognize problematic thoughts and behaviors: Through interactive question-and-answer sessions, your therapist will encourage you to pay close attention to how you respond to tough situations. You'll work together to identify unhealthy emotions, beliefs or behaviors that may be contributing to your troubles. Your therapist may ask you to keep a journal of these situations and your responses to them. Work with you to adjust your thoughts and behaviors: Your therapist will help you find ways to change negative emotions, thoughts and habits. You can change your perspective and adopt positive thought patterns and behaviors. Then, you can apply those skills to future situations. Psychodynamic Psychotherapy: Psychodynamic therapy focuses on the psychological roots of emotional suffering. Its hallmarks are self-reflection and self-examination, and the use of the relationship between therapist and patient as a window into problematic relationship patterns in the patient's life. Its goal is not only to alleviate the most obvious symptoms but to help people lead healthier lives. DSM: Diagnostic and Statistical Manual - DSM-5-TR is the standard classification of mental disorders used by mental health professionals in the United States. This is the Ortho Docs Podcast! Available everywhere you listen to all your favorite podcasts including: Apple Podcasts, Spotify, and iHeartRadio. Check out more at: maverickpodcasting.com

On this Hacks & Wonks midweek show, Crystal has a robust conversation with Damon Petrich about his research at the School of Criminal Justice at the University of Cincinnati. As lead author of the seminal work “Custodial Sanctions and Reoffending: A Meta-Analytic Review,” Damon performed an extensive analysis of 116 research studies looking at the effect of incarceration on reoffending. The review's finding that the oft-used policy of imprisonment does not reduce the likelihood of recidivism sparks a discussion about how the United States ended up as the world leader in mass incarceration and the disconnect between conventional assumptions about what prisons provide versus reality. Noting that the carceral system does a poor job of rehabilitation - while eating up budgets across the country and exacting significant societal costs - Damon and Crystal talk about how to design and evaluate programs that do work to deliver greater public safety for everyone. As always, a full text transcript of the show is available below and at officialhacksandwonks.com. Find the host, Crystal, on Twitter at @finchfrii and reach Damon for more information about his research at petricdm@ucmail.uc.edu   Resources  “Custodial Sanctions and Reoffending: A Meta-Analytic Review” by Damon M. Petrich, Travis C. Pratt, Cheryl Lero Johnson, and Francis T. Cullen for Crime and Justice: https://www.journals.uchicago.edu/doi/10.1086/715100   Scott Hechinger Twitter thread: https://twitter.com/ScottHech/status/1447596444886523911   “Mass Incarceration: The Whole Pie 2022” by Wendy Sawyer and Peter Wagner from the Prison Policy Initiative: https://www.prisonpolicy.org/reports/pie2022.html   “Risk-need-responsivity model for offender assessment and rehabilitation” by James Bonta and D. A. Andrews for Public Safety Canada: https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/rsk-nd-rspnsvty/index-en.aspx   “Let's Take a Hard Look at Who Is in Jail and Why We Put Them There” by Alea Carr for the ACLU-WA blog: https://www.aclu-wa.org/blog/let-s-take-hard-look-who-jail-and-why-we-put-them-there   Book - “Great American City: Chicago and the Enduring Neighborhood Effect” by Robert J. Sampson: https://press.uchicago.edu/ucp/books/book/chicago/G/bo5514383.html   Byrne Criminal Justice Innovation Program - “Police Legitimacy and Legal Cynicism: Why They Matter and How to Measure in Your Community”: https://www.lisc.org/media/filer_public/05/0b/050ba3aa-044f-4676-bc1e-6e2b6c48412c/091317_bcji_resources_police_legitimacy_fundamentals.pdf   “Polls Show People Favor Rehabilitation over Incarceration” by Matt Clarke for Prison Legal News: https://www.prisonlegalnews.org/news/2018/nov/6/polls-show-people-favor-rehabilitation-over-incarceration/   Transcript [00:00:00] Crystal Fincher: Welcome to Hacks & Wonks. I'm Crystal Fincher, and I'm a political consultant and your host. On this show, we talk with policy wonks and political hacks to gather insight into local politics and policy in Washington state through the lens of those doing the work with behind-the-scenes perspectives on what's happening, why it's happening, and what you can do about it. Full transcripts and resources referenced in the show are always available at officialhacksandwonks.com and in our episode notes. Well, I am excited to welcome Damon Petrich, who's a doctoral associate in the School of Criminal Justice at University of Cincinnati and incoming assistant professor at Loyola University Chicago. He was the lead author of a recent article, "Custodial Sanctions and Reoffending: A Meta-Analytic Review," along with Travis Pratt, Cheryl Lero Johnson, Francis T. Cullen. Damon's research focuses on the effectiveness of corrections and rehabilitation programs, desistance from crime, and the impact of community violence on youth development. Thank you so much for joining us, Damon. [00:01:13] Damon Petrich: Thank you very much for having me on, Crystal. I'm excited to talk a little bit about my work and the implications of that and all that, so thanks again. [00:01:20] Crystal Fincher: I'm very excited to talk about this and it's extremely timely - has been for a while. We have conversations almost every day in the public sphere having to do with public safety - this is such a major component of it. And so I'm hoping as we have this conversation, it'll help us to better assess what the costs and benefits are of custodial sanctions and incarceration, and alternatives to that - to have a conversation that kind of orients us more towards public safety. Sometimes we're so concerned with metrics around police and how many they are, and what the length of a sentence should be. And sometimes we focus on things that take us off of the overall goal of keeping us all safer and reducing the likelihood that each of us are victimized and to hopefully prevent people from becoming victims of crime. And just to have accurate conversations about how we invest our public resources - what we're actually getting from them, and then how to evaluate as we go along - what we should be tracking and measuring and incentivizing. As so many people talk about taking data-driven approaches and create all these dashboards - that we're really doing it from an informed perspective. So just to start out - what actually were you studying and what were you seeking to find out? [00:02:47] Damon Petrich: Yeah, so the main purpose of our meta-analysis, which I can explain exactly what that is later on if you have questions, but the main purpose was to understand what happens when you take one group of offenders and you sentence them to something custodial like prison or jail, and then you sentence another group of similar offenders to something non-custodial like probation. How do those two groups differ in terms of whether they reoffend? So does prison actually deter recidivism, or does it make people more likely to commit crime afterwards? So that's sort of what we were looking at and so we considered all of the available research on that, in this review. [00:03:29] Crystal Fincher: Got it. So right now we have gone down the path of mass incarceration - that is the default punishment that we, as society, have looked to for crime. Hey - sentence them and many times it's, Hey, they're going to jail. Sometimes they get out of jail and they have supervision that continues, but jail is really focused, where we focus a lot of our effort and where we put people and hope that that'll straighten them out and they come out and everything is fine. How did we get here and where are we in terms of how we're approaching incarceration in our society, in our country? [00:04:11] Damon Petrich: Yeah, so there is a lot of public uproar around a lot of issues, like race issues, and there was crime spikes and concerns over social welfare - and there's all this confluence of issues in the '60s and early '70s. And we decided to - as a country, not everyone, but politicians decided that we should tackle the crime problem by A) incarcerating more people, and then B) once they get there, keep them there for longer. So we enacted things like mandatory minimum sentences, where the judge really has no discretion over what happens - the person gets automatically a sentence of incarceration if they've committed a certain type of crime. You had habitual offender laws where if you're - like California's three strikes policy - where if you have two prior felonies and you get a third, no matter what it is, you're going to jail for life. Michigan had the "650 Lifer Law," where if you get caught with 650 grams of heroin or cocaine, you're automatically going to prison for life. And then we got rid of parole and stuff like that in a lot of states. So all these things lead to more people going to jail and then for longer, and those laws came to be in the '70s and '80s. And over that time, our incarceration rate ballooned up by about 700%, so by the early 2000s, we were at over 2 million people incarcerated and another 7-8 million people on probation or parole. So it's a pretty big expansion - the United States has 5% of the world's population and a quarter, or 25%, of the prisoners, so it's a little ridiculous. The crime rate here isn't nearly as high, or nearly high enough to justify that huge disparity. So yeah, it's a whole confluence of factors led us to be the world leader in incarceration. [00:06:14] Crystal Fincher: And what attitudes or what justifications are the people who have the power to enact these policies and continue these policies - how are they justifying them? [00:06:25] Damon Petrich: So there's a few reasons why you might want to incarcerate somebody. One is just because you want to punish them or get revenge on them, so that's more of a moral reason. But the main focus of politicians were twofold - one was incapacitation, so that one means that because you're keeping somebody locked up in a cage, obviously they can't be out in the community committing crimes. So the thought is that you're going to reduce crime that way. The research on that is a little squishy even now, and I can talk a little bit more about that later if you want. But the other reason, and the one that we focused on in our review, was that prison deters people from going back to crime after they get out. So the idea there is that prison sucks - you go in there, you're cut off from your job, from your family, from your friends, or from just having hobbies or things to do. And you're not going to want to go back, so when you get out of prison - you think real hard, and you think how much prison sucks, and you decide not to go back to crime. That's the thinking behind that deterrence hypothesis anyway. So those two - incapacitation and deterrence - were the main drivers of those increase in laws and stuff during the '70s, '80s, and '90s, but there really wasn't any evidence for either of them - in the '70s and '80s in particular. So most of the research evaluating whether prison actually does deter recidivism has popped up over the last 25 years or so. [00:08:05] Crystal Fincher: And as you took a look at it - all of the studies that have popped up over the past 25 years had varying degrees of rigor and scientific validity. But as that body of research grew, people began to get a better idea of whether incarceration actually does reduce someone's likelihood of reoffending. How big was that body of work, in terms of studies, and what were you able to look at? [00:08:40] Damon Petrich: So in our particular review, we looked at 116 studies, which is a pretty sizable number. Most people - when you read through an article and a literature review might have 10 studies or something that they just narratively go through, but we looked at 116. And then within those 116 studies, there were 981 statistical models. So 901 different comparisons - or 981 different comparisons - of what happens to custodial versus non-custodial groups. So we looked at a pretty big chunk of literature. [00:09:20] Crystal Fincher: And in that, in the reliance of - that's a really big number - and I think, people now are maybe more familiar, just from a layperson's perspective, of just how big that number is. As we've seen throughout this pandemic that we're in the middle of, studies come out - people are looking at one study, and wow - study number two comes out and we're feeling really good about it. And man, we get to five studies and people are like, okay, we know what's going on. To get beyond a hundred is just a real comprehensive body of study and analysis. What were you able to determine from that? [00:10:05] Damon Petrich: So I should probably explain upfront what a meta-analysis is and why it's useful. So like you were just saying - like in the COVID pandemic, for example - one study will come out and it'll say, oh, Ivermectin reduces symptomatic COVID cases by X percent. And then the next study will come out and say, Ivermectin makes people way worse. So any individual study can be kind of misleading. A good analogy for what a meta-analysis does would be to look at baseball, for example. So let's say you're interested in some rookie player that's just come out, he's just joined Major League Baseball and you go to his - you want to know how good this player actually is? You've never seen him play, you've only heard rumors. So you go out to his first game, he gets up to bat four times and he gets no hits. So you walk away from that game thinking, wow, this player is terrible, the team wasted all their money recruiting and paying this guy's salary. But that could have just been an off game for many reasons - it's his debut game so maybe there's just first-game nerves, maybe the weather was bad, maybe he was having personal problems in his life, or he had a little bit of an injury. So there's a number of reasons why looking at his performance from that one game is not going to be representative of who he is as a player. Ideally, you'd want to look at all the games over a season where he might go up to bat 250 times. And over those 250 times, he gets 80 hits, which is a pretty good batting average - it's over .300. So with that amount of data, you could come to a more solid conclusion of whether he's actually a good player or not. And with that amount of data, you could also look at what we call moderating characteristics. So you could look at, for example, whether he plays better when it's an away game or in a home game, whether it's early or late season - you could look at all these sorts of things. So this is essentially what we're doing with research as well, in a meta-analysis. So if you look at studies on incarceration - one might show increases in recidivism after people go to prison, the next might show decreases, and the next might show that probationers and prisoners reoffend at about the same rates. So just like in the baseball analogy, in a meta-analysis, we're looking at all of the available research. We're combining it together and determining A) what the sort of overall or average effect of incarceration is, and then B) whether these moderating characteristics actually matter. So in other words, is the effect of incarceration pretty much the same for males as it is for females, or for juveniles as adults, or when the research design is really good versus when it's not so great. So that's basically what we did in this meta-analysis is again - looked at 116 studies and from those 981 statistical estimates. [00:13:13] Crystal Fincher: Very helpful. Totally makes sense with the baseball analogy, and I especially appreciate breaking down with all the statistical models and not just kind of thumbs up, thumbs down - the binary - it either increases or reduces the likelihood of recidivism. But under what conditions are - might it be more likely, less likely that someone does? What are some of those influencing effects on what happens? And so you were just talking about the justification that people used going into this, and now that we have data coming out - does it turn out that people go into prison or are incarcerated in jail, they think - wow, this is horrible. Some in society are like the more uncomfortable we make it in jail, the better we want to make sure it's a place that they never would want to come back to - that it's so scary and such a bad experience that they are just scared straight for the rest of their lives. Does it actually turn out to be that way? Do they take a rational look at - this was my experience, I don't want to go back again, therefore I will not do any of the things that I did going in. [00:14:28] Damon Petrich: I would not say that's the conclusion - no. So again, based on the 116 studies that we looked at, which is again a lot, people who are sentenced to incarceration - so jail, prison - they commit crime, they reoffend at about the same rates as if you'd sentence those same people to probation. So in other words, they're not being deterred by being sent to prison. These effects are the same for both males and females. So in other words, prison doesn't reduce reoffending for one group versus the other. It's the same whether we look at adults versus juveniles, it's the same regardless of what type of recidivism we're interested in - rearrests or convictions. It's pretty much the same across the board. There's some slight variations in research designs, but even within those, prison either has no effect or it slightly increases recidivism. We don't find any conditions under which prison is reducing reoffending or deterring these people from going back to those lives. [00:15:35] Crystal Fincher: So from a societal perspective, a lot of people kind of make the assumption that, Hey, we arrest and we incarcerate someone - whew, our streets are safer. They get out, and now they can choose to reintegrate themselves into society hopefully - they do and we're all safer because of it. But it looks like impressions that some people may have that, Hey, we're letting someone off easy. And suggestions - there's so much media coverage around this - and suggestions that because we're letting people off easy, that we're making it easier for them to reoffend, or they don't feel sufficiently punished enough and so that becomes an incentive to reoffend. Does that seem like it tracks with what the studies have shown? [00:16:33] Damon Petrich: Not really - so there's some studies that actually ask prisoners and offenders whether they'd prefer going to prison or probation. And a lot of them will say, oh, I'd rather do a year in prison than spend two or three years on probation. So it's not like they view probation as just being super easy. And they're not saying this because they received time off their sentence for being in the study or anything like that. Probation's not easy either - and you have to also think that while these people are on probation, they're able to stay in close touch with their family, they're able to maintain connections with work or find work, they're able to participate in the community, they can pay taxes - that I know a lot of people who are pro-prison love. So there's all sorts of reasons why - beyond just them reoffending at the same rates as if they'd gone to prison - there's a lot of reasons why we might want to keep these people in the community. And it's not like we're saying, let everybody out of prison - so the nature of this research - you want to compare apples to apples. So in this research, comparing prisoners to probationers - these have to be people who are getting - they could either legitimately get a sentence of jail or probation, or prison or probation. So these are going to be first-time offenders, people who are relatively low-level - they've committed low-level crimes and all that. So we're not saying - there's not going to be a situation where a murderer just gets probation - that sort of thing. So I know that might be a concern of some people - they think that's a natural argument of this analysis, but it's really not. [00:18:24] Crystal Fincher: Well, and to your point, we're really talking - if we're looking at all of the crime that gets people sentenced to prison time, a very small percentage of that is murder. A very small percentage of it is on that kind of scale - you can wind up in jail or prison for a wide variety of offenses - many of them, people perceive as relatively minor or that people might be surprised can land you in prison. Or if someone has committed a number of minor offenses, that can stack up - to your point in other situations - and increase the length of detention or the severity of the consequences. As we're looking through this and the conversation of, okay, so, we sentence them, we let them out - it's not looking like there's a difference between jail or community supervisions, things like probation - what is it about jail that is harmful or that is not helpful? What is it about the structure of our current system that doesn't improve recidivism outcomes for people? [00:19:42] Damon Petrich: Probably the main one is the rehabilitation is not the greatest. So just as an example, substance abuse is a very strong predictor whether people are going to reoffend, unsurprisingly. About 50% of prisoners at the state and federal level in The States meet the DSM [Diagnostic and Statistical Manual of Mental Disorders] criteria for having a substance use abuse disorder - so they meet the clinical criteria for substance abuse disorder. So half of them, and then more than that just use substances, but they don't meet the criteria for a disorder. But of that 50% who has a substance abuse disorder, only about 20% of those actually receives treatment for it while they're incarcerated. So, you're not dealing with a root cause of reoffending while they're in prison - so you're not deterring them, but you're also not rehabilitating them - so you're really not doing anything. And then in the rare cases where these people are provided with rehabilitation or reentry programming, it's often not based on any sort of evidence-based model of how you actually change people. So there's a lot of psychological and criminology theory and research on how you actually elicit behavioral change, and these programs really aren't in line with any of that. And I could give examples if you wanted, but - [00:21:17] Crystal Fincher: Sure. I think that's helpful, 'cause I think a lot of people do assume, and sometimes it's been controversial - wow, look at how much they're coddling these prisoners - they have these educational programs, and they get all this drug treatment for free, and if they don't come out fixed then it's their own fault because they have access to all of these treatment resources in prison. Is that the case? [00:21:43] Damon Petrich: No, I wouldn't say so - first of all, they don't have access, a lot of them, to any programs. And then, like I said, the programs that they do get really aren't that effective. So the big one that everybody loves to argue for is providing former inmates with jobs. If you look at any federal funding for program development, like the Second Chance Act or the First Step Act - I think that was one under Trump - and then under Bush, there was a Serious [and] Violent Offenders Reentry Initiative - pretty much all of these federal bills will be heavily focused on just providing offenders with jobs. And almost all of the evaluations of these programs show that they don't reduce reoffending. And it's not really that hard - again, if you go back to the literature on behavioral change and, criminology literature - it's not really that hard to understand why just providing a job isn't going to reduce or lead somebody away from a life of crime. A lot of these people have spotty work histories where they've never had a job at all, they believe and know that it's easier to gain money by doing illicit work than it is legal work, they have things like low self-control so they're very impulsive, they don't know how to take criticism or being told what to do by a boss. They live in neighborhoods with very poor opportunities for good jobs and education, and maybe there's a mindset around there that illegal work or whatever is just a better way to go - that's sort of ingrained. So there's a lot of different reasons why just handing somebody a job isn't going to lead them away from crime, 'cause they have all these other things that need to be dealt with first. So ideally, a rehabilitation program that's comprehensive would deal with all of those other background factors and then provide them with a job. Because if you make them less impulsive, better able to resist the influence of their antisocial friends, and get this thought out of their head that other people are being hostile towards them when they're really not - all these sorts of cognitive and behavioral biases that they have - if you deal with all of those things and then you give them a job, they're more likely to actually latch onto that job as something worthwhile doing. And then they're going to go on to get out of a life of crime. But if you just give them a job and you haven't dealt with any of those issues, you can't really expect that to work. And that is the model that we currently do - is something that we don't really expect to work that well. [00:24:28] Crystal Fincher: Yeah, that's - it's really interesting and I don't know that a lot of people actually know that, Hey, giving someone a job isn't sufficient - which is why I think it's so important to talk about studies like this, because some of what has become conventional wisdom, really is not accurate or reflects what has been studied and discovered. And I guess in that vein, what are the factors - you just talked about a few - but what does increase someone's likelihood of reoffending or recidivism, and what reduces it? [00:25:08] Damon Petrich: So those are probably two ends of the same, or two sides of the same coin, but this is pretty well known in criminology - a model called the risk-need-responsivity [RNR] model was developed by a couple of fellow Canadians, named James Bonta and Don Andrews, along with some of their colleagues in the '80s and '90s. And they, through again, other meta-analyses just like we did, found certain categories of characteristics of people who are more likely to reoffend. So you have things like having antisocial peers - so that one's pretty obvious - if you have a bunch of friends that are involved in crime, it's going to be pretty hard for you to get out of that life because you're surrounded by those people. Same with family members. If you have what are called criminal thinking patterns - so again, you might have what's called a hostile attribution bias, things like that, where somebody says something a little bit negative to you and you take that as a huge insult and you retaliate with anger and aggression - things like that. Or being impulsive - so you're again quick to anger, you're swayed by small little enticements in the environment and that sort of thing - so you're easily swayed one way or the other. Things like that are strong predictors of reoffending. Substance abuse - it's what I mentioned earlier. If you don't really have any sort of proactive leisure activities, like hobbies and stuff like that. So there's a bunch of well-known things that we know are strongly associated with recidivism, and a rehabilitation program should ideally deal with them. Now this model that Andrews and Bonta and all these other people came up with - this RNR risk-need-responsivity model - the risk part says that we should give people a risk assessment when they're entering prison or leaving prison and determine what level of risk are they from reoffending. And we assess these different criteria, like criminal thinking patterns and antisocial friends and substance abuse. So we determine what those factors are and then we design them a treatment program that actually deals with those factors at the individual level. So we're not just giving a blanket rehabilitation program to everybody, and you're providing the most amount of care to the people who most need it or who are the most likely to re-offend. And then once we've done all that, we need to make sure that we're addressing these problems in some sort of a format that we know actually works. The most well-known one, but not as often used, the most well-known within the sort of psychologist and criminological literature is cognitive behavioral therapy [CBT]. So this is pretty popular for dealing with depression and all sorts of eating disorders and substance abuse problems in non-offender populations. Well, those programs also work in offender populations and they work pretty well. So the research shows - again meta-analyses - that when you deal with all these three factors - risk, need, and responsivity - you can reduce reoffending rates by about 26%. So it's a pretty sizeable amount - it's much greater than you're getting by just sentencing people to prison without doing anything. [00:28:42] Crystal Fincher: Absolutely, and I think you cover in your paper - those things are absolutely true. And you just talked about several administrations' attempts to implement programming and resources to try and help people get jobs, potentially - hey, there's even a CBT treatment, but if that treatment has twice as many people as are recommended being in a session and occurs over half the time that it's supposed to, you really are sabotaging the entire process or really setting it up for failure. And it just seems to be an expensive exercise that we aren't really getting anything out of. Does that seem to be consistent with how you've seen the attempts at introducing this programming within prisons and jails? [00:29:40] Damon Petrich: Yeah, for sure - this is a pretty common finding too - so it's not just about preaching that you're going to do these things. You actually have to implement them well. So just like you said, there's a number of studies that show this - so you've designed some really great program that deals with all of these risk factors that lead people back into reoffending, you give it to them in a cognitive behavioral setting. So all seems good on paper, but in practice, like you said - one of the famous studies there - can't remember the names of the authors offhand right now - but one of the famous studies there showed that they're providing it to people in groups of 30, as opposed to 15, and they're delivering it in a really short amount of time. And they're not maybe giving it to the highest-risk people - so they're just mixing random people in there at varying levels of risk. So when you do all these sorts of things - you implement the program poorly - you can't really expect it to work. And this is often the case - is the government pays people to come up with these great programs, and then not enough funding is provided to actually make sure that they're implemented and evaluated well. So the amount of funding that actually goes into that - developing the programs to begin with - is small, but when you do do that, you're not making sure that you're actually implementing things well. So it's just sort of shooting yourself in the foot, and probably making people come to the conclusion that these things don't work - when they do work, if you just implement them well. [00:31:17] Crystal Fincher: Yeah, and there's also a lot of rhetoric - and you discuss this - there's a lot of rhetoric coming from the government, even coming from leadership within the Bureau of Prisons or leadership in our carceral system, saying we do want to rehabilitate people. We are trying to implement programming that does this. You see - we have these educational opportunities and we are doing evaluations of people. And it may be happening while they're understaffed or other challenges, but one of the biggest, I guess, red flags is that none of the evaluation of their programs and none of the incentives that arise are in any way tied to what is the actual result of what happens. Are you actually succeeding on reducing someone's likelihood for reoffense? It does not seem like any compensation is tied to that, any kind of evaluation of positions or regular reporting - to say, is this program having its intended effect? And if not, what do we need to do to correct for that? Is that what you found? [00:32:33] Damon Petrich: I would say that's probably a pretty fair assessment. A lot of the programs that are implemented are never evaluated at all. And then the ones that are - it's usually once - there's one evaluation of those programs. And then, like you said, there doesn't really seem to be a lot of self-reflection - I don't know what other word you would use - but these programs don't really change on the basis of these evaluations. So, it's kind of disheartening to hear about, I guess. [00:33:14] Crystal Fincher: It feels very disheartening to live in the middle of - and one of the big things about this is that this - we have these conversations and we talk about these studies and we're saying, yeah, it actually - we're not doing anyone any favors right now when it comes to reducing recidivism. And having these conversations oftentimes detached from the cost associated with what we're paying for these. And my goodness are we paying to incarcerate people? It's not just, well, we do lock them up and we keep them away. Or we do a good job of keeping them in - they reoffend, they go back to jail. And lots of people are like, we did our job, they went back to jail - boom, everything is fine. But we are paying through the nose and out the ear for this - just here, we're in the state of Washington, and right now the state spends about $112 per day, or over $40,000 annually, to incarcerate one individual - that's the cost per inmate. In King County - the county that we're in - they spend $192 a day, or $70,000 annually, to incarcerate an individual. That is a huge amount of the tax dollars that we spend - these come out of our general fund, meaning that these are dollars that every service, everything that is not a dedicated source of revenue, is competing for. So when we talk about things and have conversations like, well, we don't have the budget for that and we don't have the money - that is related to how much of that money we're spending on other things. And my goodness, I would think that we want to get our money's worth for that level of expenditure. And it really appears that if we're saying the goal of jail is to get people on the straight and narrow path and becoming contributing members of society and all of the implications of that, it doesn't seem like we're getting our money's worth. And so, if those aren't the goals and if we just want to punish people, it's not like we're punishing people for free. We're punishing people at the cost of $70,000 per day [year], and at the cost of all the other services and infrastructure needs that we have. So it really seems like we're punishing ourselves as much, or more, as others - particularly if we're bringing people back into society that are likely to reoffend in one way or another. And so if our goal is to keep our community safe and that is the North Star, it looks like we need to realign our processes and our expenditure of resources. I guess my question to you, after all that, is - how should we be moving forward? What should we be looking to do? What is shown to work? [00:36:24] Damon Petrich: Well, I would say - yeah, $70,000 a year as just a revenge cost per person seems like a lot. $80 billion in the country as a whole, for a revenge cost, seems like a pretty high price to pay, given we're not reducing reoffending. You could make the argument that these people aren't offending while they're in prison, but that's - there's other reasons why that might not be completely accurate, which I could talk about too, but - [00:36:59] Crystal Fincher: Well, I'm interested in that. Why might that not be accurate? [00:37:03] Damon Petrich: So, obviously the person - if you incarcerate a particular individual, obviously they can't be out in the community committing crimes. So that's obvious, but there's a number of reasons why that might not, en masse, actually reduce crime a whole lot. The research on it - this is a little bit squishy - in terms of whether incarcerating more people leads to lower crime rates, because one influences the other. But for example, if you look at illegal drug markets - a lot of the homicides in the United States and other violent crime that people are really concerned about, and it's plastered all over the media is - homicides, gang-related stuff. So if you take key gang members out and you put them in prison, what ends up happening is that there's competition in that market to take over that person's place, either within the gang or other gangs coming in. So what ends up happening oftentimes is a spike in violence. So that's one reason why just incapacitating, particularly high-crime individuals, might not actually lead to lower crime rates overall. Again, you're lowering crime for that one person, but you might be increasing crime on a more systemic level. Beyond that, these things have broader societal and community level impacts - incarcerating a lot of people. Again, research shows that when you're incarcerating a lot of people in a particular community - so there's a bunch of really good work by Robert Sampson - he has a book that came out a few years ago called Great American City. And he looked at these individual neighborhoods in Chicago over time, and what he finds is that in communities where there's a higher number of people incarcerated in a particular community, this ends up increasing what's called "legal cynicism." And this is done in some other work as well with David Kirk and Andrew Papachristos - but they show that this increases legal cynicism, which means people are skeptical of police helping them out, the police doing a good job. And what ends up happening after that - when people are more cynical of the legal system, they're less likely to report crimes to the police, they're less likely to cooperate with the police. So what ends up happening? You incarcerate more people and people in that community end up being less willing to cooperate with law enforcement. And this leads to sort of an endless cycle where things sort of get out of hand. So there's all these unintended and nonfinancial consequences of incarcerating a lot of people that could potentially end up leading to more crime. [00:40:03] Crystal Fincher: Well, and - speaking as a Black woman - obviously, looking at the impacts of mass incarceration in the Black community and in neighborhoods around the country - where it is almost like the community is responding to the actual outcome and that, Hey, this actually isn't making my community any better. I'm experiencing traumatic impacts from this - whether it's my relative went to prison or a sole breadwinner in the family and now we're thrown into poverty, or I'm in a situation where I don't have a parent who used to be there - who now is no longer there. Or causing instability and impacting the education that people get and the kind of job opportunity, watching someone who's come out have to struggle and be ostracized. And it looks like, Hey, this is just the first step on a long cycle of traumatic and undesirable events - and I don't want to participate in a system that is doing that. With that, as we look forward, and I think this is also related to conversations about just fundamental trust in our criminal legal system and relations with police and throughout the system. It's - if we think about how to turn that around - to me, seems related to thinking about the question of how do we get better outcomes for everyone? 'Cause it seems like right now where we're investing a lot in poor outcomes for people who were already, usually, in pretty poor spots leading to themselves being incarcerated, coming out and not necessarily improving, definitely not improving. And if anything, a chance that it gets a little bit worse. How do we change that entire outcome? And I know you're looking specifically in the incarceration space, but what should be, what could be done differently? Or do we just need a fundamental restructuring of the way we do this? [00:42:17] Damon Petrich: I don't know about a fundamental restructuring - I don't, I'm not great at that high-level thinking stuff, but what I do know is that - we're probably going to continue to incarcerate people. That's something that's done in every country and people seem to love here. So if we actually want to use prison for public safety - because 95% of inmates eventually get out - if we actually want to use it for public safety, then let's actually try wholeheartedly to rehabilitate them while they're in there. And again, there's a lot of theory and evidence-based principles on how we can do this, like the risk-need-responsivity model that I talked about earlier, cognitive behavioral therapy more broadly. If you use these types of things and continue to work on them and develop them over time, then yeah - prison might actually be helpful if people are going there and getting the help that they need. But that's not what's happening currently. So that's one level in incarceration terms - that's the area that I know best. So that's one way you could potentially alleviate some of this stuff is - if people are actually getting resources and stuff when they're in prison, and then when once they're reintegrating, they're not only going to reoffend less, but maybe they're going to contribute to their community more. They're going to be better able to connect with their family and stuff like that. So rather than being a hindrance, it could potentially be a help. Obviously, again, it's not ideal to remove people from their communities and their family and friends. And like I said earlier, if you have the option to sentence them to something community-based instead, I think that's the better route to go. But if you are going to send people to prison, which I think we're going to continue to do a lot of the time, then let's rehabilitate them while they're in there is the main point. And do so based on what actually works to do that. [00:44:23] Crystal Fincher: It's really the investment in the people who are there, and we're - I think up against a lot of societal attitudes and resistance where it just feels wrong to a number of people to be providing services and shifting that investment to things that are seemingly helpful for the inmate, because everything about how we've been conditioned to understand our prison system has been - the punishment is kind of the key, and they'll make rational decisions afterwards to avoid prison based on how bad the punishment is. When it comes to community supervision, things like probation, what are the differences there? If there are better outcomes from that, what accounts for the better outcomes when it comes to probation versus incarceration? [00:45:23] Damon Petrich: I wouldn't say the outcomes are better - they're just pretty much the same as they would be if they're sentenced to prison. So, probation costs less and then it also enables the people to be out in the community doing community things, like being with their friends and families and all that. I mean, you can't quantify, based on a recidivism percentage, what their family members and friends and employers are getting out of it. So that's something we can't really look at - or I guess you could, but something we don't often do - but so there's intangible things that you would get by keeping people in the community. Plus it doesn't lead to all that other stuff I talked about where people become cynical of the legal system and it leads to this cycle of whatever. [00:46:11] Crystal Fincher: Yeah, and so if we're were doing this programming in prison and helping people, I think your research shows it's extremely important to do both the structural, Hey, you need a place to live, you need to be able to pay your rent and your bills - so having a job, having housing, having healthcare, getting those very basic needs met is critical. But also addressing a number of the mental or behavioral health issues that are common among the incarcerated population - and dealing with that is as important. And basically those two things both need to happen hand-in-hand. How do we do a better job of that in our current system? [00:46:57] Damon Petrich: Well, first of all, I'd like to say that you're right there - I think maybe when I was talking earlier about employment, it might sound like giving people jobs is just a waste of time, but that's not the case. It needs - the two things need to be paired - you need to deal with the cognitive and behavioral problems in addition to giving them jobs and housing support and all that. In terms of how you actually go about doing that, there are examples in the literature of programs that do this, so there's examples out there. I think if you're a state or local or even federal correctional department and you're interested in doing this - implementing something that's evidence-based - or if you're just a concerned citizen that wants to rally your local officials to do that - go and talk to researchers like me, or people at universities that have criminology departments or criminal justice departments, because this knowledge is out there. It's widely available. You just have to go and seek it out. So at my university, for example, we have the University of Cincinnati Corrections Institute and under the guidance of Ed Latessa, he was - now passed - but he was, over the last 30 years, responsible for disseminating a lot of this evidence-based practices to some of the state and local criminal justice agencies. And they helped with implementation and evaluation in a lot of these places, so the help is out there. You just have to look for it a little bit. [00:48:38] Crystal Fincher: And another question I had - your analysis seemed to suggest that when we're talking about low-risk, medium, and high-risk offenders - or people who have done relatively minor crimes versus those who have done more serious crimes - that these interventions are particularly effective the more serious the offense or crime has been. And that perhaps even sometimes treating someone who is a really low-risk as if they're a high-risk, can worsen the outcomes for that person. Is that the case? [00:49:21] Damon Petrich: Yeah, that tends to be a finding in research - we're not exactly sure why, but providing a lot of really intensive services to people deemed to be low-risk can actually be harmful rather than helpful. We don't know based on research why, but there's a lot of pretty good hypotheses about why. So a low-risk offender is going to be somebody who's a first-timer who's committed some not-that-serious crime. So they probably have a job, they probably have pretty strong connections with their family and all that. So if you're taking them and you're putting them in a program where you have to be there 40 hours a week, they're probably going to get fired from their job, it's going to be harder to stay in contact with friends and families that are sort of tying you into a non-criminal life. And then you're probably going to be associating with all kinds of people who are high-risk, and maybe they're going to draw you towards, oh yeah, I could earn four grand going out tonight and stealing some laptops. There's a lot of reasons why just taking low-risk people and putting them in these programs is going to be harmful rather than helpful. [00:50:31] Crystal Fincher: And so with that in mind, and you talk about, Hey, if we're trying to influence local electeds - one of the interesting things about having a podcast and radio show that caters to extremely politically and civically inclined people is that we actually do have a number of policymakers and politicians who listen, and people who are enacting and in control of this policy. If you were to talk to them and give them advice about how to move forward, especially in the current environment that we find ourselves in, where over the past few years has been increasing awareness of some of the defecits of our system and pushes to change those. And also, as we have seen more recently, a real strong pushback from a lot of people who are invested in our current system saying, Hey, let's not change things too much. Maybe we need to jail more and for longer. And maybe we're just not doing enough incarceration, and that's the answer. In that kind of political environment, what would you tell people who are in charge of this policy, who may be facing pressure to keep going forward with the status quo, about how they should evaluate how they should move forward and the kinds of things that they should do? [00:52:07] Damon Petrich: I know a lot of these politicians get lobbied by correctional officer groups or whatever, and that's whatever, but ultimately you get voted in by voters. So, I'm not an expert on public opinion - I have other friends who are more into that kind of stuff, but I do know from talking with them and from reading that literature, that the public actually does support rehabilitation. So they have for a long time and it's shifted more towards being in support of rehabilitation over time. So right now, most Americans support providing rehabilitation programs to prisoners and offenders. So this is something that's going to please your constituency, people want this kind of thing. And it's not like you're going to be losing all kinds of jobs by getting rid of prison - there's going to be a need for skilled people who can provide these programs and probation officers and all these sorts of things. So it's not a net loss when you're getting rid of prisons. There's a lot of reasons to sentence people to community supervision and things like that - provide rehabilitation. There's public support for it, there's jobs involved, there's cost savings - big time, obviously - it's way cheaper to keep somebody out of prison than it is to keep them in prison. So there's a lot of different reasons why you would want to do that as a politician. [00:53:43] Crystal Fincher: I think that makes sense. Certainly it's a lot cheaper to keep someone out of prison versus in prison. I mean, we talked about the annual costs - in the state of Washington over $40,000, King County over $70,000 - comparing that to how much we invest in a student of $11,500 a year. If we focus more on investing in people, both inside and outside the system, it seems like we set ourselves up for a safer community, fewer people being victimized, and more people leading thriving, productive, tax-paying lives. And we're all happier than we are right now, I would think, I would hope - it seems like the research points in that direction. So I certainly appreciate you taking the time to speak with us about this. Is there anything else that you want to leave with us, in thinking about this study and your research? [00:54:55] Damon Petrich: I think we covered it pretty well. Just to circle back to something you just said - I know this might put me out of a job since I focus on what happens when people's lives go awry, but you really are better off to invest in early prevention programs and giving people a good start on life than trying to correct the program or the problem afterwards. So yeah - politicians spend some money on prevention programs. I know the good effects of that are a long way out, but they're actually good on a societal level. So I guess I would add that, even though it's not good for criminologists, maybe, to put themselves out of a job like that. [00:55:40] Crystal Fincher: Well, much appreciated, and thank you so much for having this conversation with us today. [00:55:45] Damon Petrich: Yeah, thank you very much for having me on. I'm glad that there are people out there interested in this stuff, so thanks again. [00:55:51] Crystal Fincher: I thank you all for listening to Hacks & Wonks on KVRU 105.7 FM. The producer of Hacks & Wonks is Lisl Stadler with assistance from Shannon Cheng. You can find me on Twitter @finchfrii, spelled F-I-N-C-H-F-R-I-I. Now you can follow Hacks & Wonks on iTunes, Spotify, or wherever else you get your podcasts - just type "Hacks and Wonks" into the search bar. Be sure to subscribe to get our Friday almost-live shows and our midweek show delivered to your podcast feed. If you like us, leave a review wherever you listen to Hacks & Wonks. You can also get a full transcript of this episode and links to the resources referenced in the show at officialhacksandwonks.com and in the episode notes. Thanks for tuning in - we'll talk to you next time.

In today's episode of Beyond the Therapy Session, George and Erin discuss the topic of anxiety. They define anxiety as per the DSM ( Diagnostic and Statistical Manual of Mental Disorders) and distinguish between generalized anxiety, panic attacks, panic disorders and stress. Erin establishes the identifying symptoms of each, the possible causes of anxiety and what happens when it goes untreated. This episode also covers tools for experiencing relief from anxiety, how to be an appropriate support to a loved one and the role of medication in anxiety management.

Summary This week Hasna and Alison talk about standardized tests. They explore what standardized tests measure, how schools filter students using these tests, consequences of the tests on parents and kid and wrap up with talking about the DSM-5.   Topics 00:00 - This Life, the chronicles of Autism moms podcast, series 1 episode 15 – Standardized Testing with Hasna. 00:01 – What is standardized Testing? 01:50 – Why was Standardized Testing created? 02:30 – When would it be appropriate for our neurodiverse children to have such testing? 03:00 – Standardized Testing immediately puts a non-Standard child at a disadvantage 04:00 What does the test consist of? 07:00 – What are the consequences of these tests for our children? 09:00 – Current tests are so outdated they do not reflect what the child is actually capable of. 09:30 – A huge shift in testing is required, how do think this can be done? 10:20 – DSM – Diagnostic and Statistical Manual of Mental Health Disorders – This manual is periodically updated, for example between version 4 and 5, Autism and Aspergers were redefined. Constantly evolving according to research. 13:00 – There are no current accommodations with the standardized tests for special needs children they are being compared to neurotypical children. --- To learn more about navigating the school process, watch Learn Autism's video: Evaluation process and effective school inclusion To learn more about Autism, visit: www.learnautism.com To watch this podcast, visit our YouTube Channel. --- Keep in touch with us on Instagram  @chroniclesofautismmomspod Download the Learn Autism app today:  

Today I have a very special treat As we have two guests on the show. First, we have Sarah Fay who is an award winning author and mental health advocate working to improve how we think and talk about our mental health by moving the conversation away from simplistic diagnoses and toward a deeper understanding of our mental and emotional lives. Her personal experience of being diagnosed with six different mental health disorders and finding no relief led her to investigate the diagnoses that we receive and to write her journalistic memoir, Pathological: The True Story of Six Misdiagnoses, which apple book shows as one of the best books in March. Joining her to unpack a lot of this and more is Dr. Thomas Insel who's a psychiatrist and neuroscientist who has been a national leader in mental health research, policy, and technology. From 2002 to 2015, Dr. Insel served as director of the National Institute of Mental Health.    We talk about why diagnoses and symptoms shouldn't be the focus in treating our mental health, how we should work on ourselves first and allow healing, why we should not allow what we are growing through to define our identity, and so much more!  Thanks to this episode's sponsor: Join Thrive Market today to get 40% off your first order and a free gift worth over $50. Visit thrivemarket.com/dougfitness. Earth Echo Foods/Cacao Bliss: www.earthechofoods.com/dougbopst Use Promo code "Doug" at checkout to receive 15% off your order  What to Listen For: 00:00 Intro 02:04 Almost in any measure of public health, we suck 05:36 What is DSM (Diagnostic and Statistical Manual)? 08:56 Unconsciously becoming anorexic 14:34 “The focus was on my symptoms, not on my life.” 17:58 Identifying with your diagnosis 21:59 “I was never given a future.” 25:37 We have to disguise illness from identity 30:24 Is it just a collection of symptoms? 34:34 Prescriptions aren't necessarily the answer 38:42 Two steps to restoring mental health 42:27 The metaphor of a broken leg 47:08 Getting therapy out of helping others 49:23 The correlation of our physical and mental health 55:24 Finding out mental health diagnoses are invalid 59:03 When healing doesn't feel like punishment anymore 01:02:16 Everything we need is hiding in plain sight  Episode Resources: Dr. Thomas Insel | Website, Twitter, LinkedIn, Book Mind Site News Sarah Fay | Website, Instagram, Facebook, Book Pathological: The Movement Follow me on Social Media: LinkedIn Instagram Twitter

On this Hacks & Wonks midweek show, Crystal has a robust conversation with Damon Petrich about his research at the School of Criminal Justice at the University of Cincinnati. As lead author of the seminal work “Custodial Sanctions and Reoffending: A Meta-Analytic Review,” Damon performed an extensive analysis of 116 research studies looking at the effect of incarceration on reoffending. The review's finding that the oft-used policy of imprisonment does not reduce the likelihood of recidivism sparks a discussion about how the United States ended up as the world leader in mass incarceration and the disconnect between conventional assumptions about what prisons provide versus reality. Noting that the carceral system does a poor job of rehabilitation - while eating up budgets across the country and exacting significant societal costs - Damon and Crystal talk about how to design and evaluate programs that do work to deliver greater public safety for everyone. As always, a full text transcript of the show is available below and at officialhacksandwonks.com. Find the host, Crystal, on Twitter at @finchfrii and reach Damon for more information about his research at petricdm@ucmail.uc.edu   Resources  “Custodial Sanctions and Reoffending: A Meta-Analytic Review” by Damon M. Petrich, Travis C. Pratt, Cheryl Lero Johnson, and Francis T. Cullen for Crime and Justice: https://www.journals.uchicago.edu/doi/10.1086/715100   Scott Hechinger Twitter thread: https://twitter.com/ScottHech/status/1447596444886523911   “Mass Incarceration: The Whole Pie 2022” by Wendy Sawyer and Peter Wagner from the Prison Policy Initiative: https://www.prisonpolicy.org/reports/pie2022.html   “Risk-need-responsivity model for offender assessment and rehabilitation” by James Bonta and D. A. Andrews for Public Safety Canada: https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/rsk-nd-rspnsvty/index-en.aspx   “Let's Take a Hard Look at Who Is in Jail and Why We Put Them There” by Alea Carr for the ACLU-WA blog: https://www.aclu-wa.org/blog/let-s-take-hard-look-who-jail-and-why-we-put-them-there   Book - “Great American City: Chicago and the Enduring Neighborhood Effect” by Robert J. Sampson: https://press.uchicago.edu/ucp/books/book/chicago/G/bo5514383.html   Byrne Criminal Justice Innovation Program - “Police Legitimacy and Legal Cynicism: Why They Matter and How to Measure in Your Community”: https://www.lisc.org/media/filer_public/05/0b/050ba3aa-044f-4676-bc1e-6e2b6c48412c/091317_bcji_resources_police_legitimacy_fundamentals.pdf   “Polls Show People Favor Rehabilitation over Incarceration” by Matt Clarke for Prison Legal News: https://www.prisonlegalnews.org/news/2018/nov/6/polls-show-people-favor-rehabilitation-over-incarceration/   Transcript [00:00:00] Crystal Fincher: Welcome to Hacks & Wonks. I'm Crystal Fincher, and I'm a political consultant and your host. On this show, we talk with policy wonks and political hacks to gather insight into local politics and policy in Washington state through the lens of those doing the work with behind-the-scenes perspectives on what's happening, why it's happening, and what you can do about it. Full transcripts and resources referenced in the show are always available at officialhacksandwonks.com and in our episode notes. Well, I am excited to welcome Damon Petrich, who's a doctoral associate in the School of Criminal Justice at University of Cincinnati and incoming assistant professor at Loyola University Chicago. He was the lead author of a recent article, "Custodial Sanctions and Reoffending: A Meta-Analytic Review," along with Travis Pratt, Cheryl Lero Johnson, Francis T. Cullen. Damon's research focuses on the effectiveness of corrections and rehabilitation programs, desistance from crime, and the impact of community violence on youth development. Thank you so much for joining us, Damon. [00:01:13] Damon Petrich: Thank you very much for having me on, Crystal. I'm excited to talk a little bit about my work and the implications of that and all that, so thanks again. [00:01:20] Crystal Fincher: I'm very excited to talk about this and it's extremely timely - has been for a while. We have conversations almost every day in the public sphere having to do with public safety - this is such a major component of it. And so I'm hoping as we have this conversation, it'll help us to better assess what the costs and benefits are of custodial sanctions and incarceration, and alternatives to that - to have a conversation that kind of orients us more towards public safety. Sometimes we're so concerned with metrics around police and how many they are, and what the length of a sentence should be. And sometimes we focus on things that take us off of the overall goal of keeping us all safer and reducing the likelihood that each of us are victimized and to hopefully prevent people from becoming victims of crime. And just to have accurate conversations about how we invest our public resources - what we're actually getting from them, and then how to evaluate as we go along - what we should be tracking and measuring and incentivizing. As so many people talk about taking data-driven approaches and create all these dashboards - that we're really doing it from an informed perspective. So just to start out - what actually were you studying and what were you seeking to find out? [00:02:47] Damon Petrich: Yeah, so the main purpose of our meta-analysis, which I can explain exactly what that is later on if you have questions, but the main purpose was to understand what happens when you take one group of offenders and you sentence them to something custodial like prison or jail, and then you sentence another group of similar offenders to something non-custodial like probation. How do those two groups differ in terms of whether they reoffend? So does prison actually deter recidivism, or does it make people more likely to commit crime afterwards? So that's sort of what we were looking at and so we considered all of the available research on that, in this review. [00:03:29] Crystal Fincher: Got it. So right now we have gone down the path of mass incarceration - that is the default punishment that we, as society, have looked to for crime. Hey - sentence them and many times it's, Hey, they're going to jail. Sometimes they get out of jail and they have supervision that continues, but jail is really focused, where we focus a lot of our effort and where we put people and hope that that'll straighten them out and they come out and everything is fine. How did we get here and where are we in terms of how we're approaching incarceration in our society, in our country? [00:04:11] Damon Petrich: Yeah, so there is a lot of public uproar around a lot of issues, like race issues, and there was crime spikes and concerns over social welfare - and there's all this confluence of issues in the '60s and early '70s. And we decided to - as a country, not everyone, but politicians decided that we should tackle the crime problem by A) incarcerating more people, and then B) once they get there, keep them there for longer. So we enacted things like mandatory minimum sentences, where the judge really has no discretion over what happens - the person gets automatically a sentence of incarceration if they've committed a certain type of crime. You had habitual offender laws where if you're - like California's three strikes policy - where if you have two prior felonies and you get a third, no matter what it is, you're going to jail for life. Michigan had the "650 Lifer Law," where if you get caught with 650 grams of heroin or cocaine, you're automatically going to prison for life. And then we got rid of parole and stuff like that in a lot of states. So all these things lead to more people going to jail and then for longer, and those laws came to be in the '70s and '80s. And over that time, our incarceration rate ballooned up by about 700%, so by the early 2000s, we were at over 2 million people incarcerated and another 7-8 million people on probation or parole. So it's a pretty big expansion - the United States has 5% of the world's population and a quarter, or 25%, of the prisoners, so it's a little ridiculous. The crime rate here isn't nearly as high, or nearly high enough to justify that huge disparity. So yeah, it's a whole confluence of factors led us to be the world leader in incarceration. [00:06:14] Crystal Fincher: And what attitudes or what justifications are the people who have the power to enact these policies and continue these policies - how are they justifying them? [00:06:25] Damon Petrich: So there's a few reasons why you might want to incarcerate somebody. One is just because you want to punish them or get revenge on them, so that's more of a moral reason. But the main focus of politicians were twofold - one was incapacitation, so that one means that because you're keeping somebody locked up in a cage, obviously they can't be out in the community committing crimes. So the thought is that you're going to reduce crime that way. The research on that is a little squishy even now, and I can talk a little bit more about that later if you want. But the other reason, and the one that we focused on in our review, was that prison deters people from going back to crime after they get out. So the idea there is that prison sucks - you go in there, you're cut off from your job, from your family, from your friends, or from just having hobbies or things to do. And you're not going to want to go back, so when you get out of prison - you think real hard, and you think how much prison sucks, and you decide not to go back to crime. That's the thinking behind that deterrence hypothesis anyway. So those two - incapacitation and deterrence - were the main drivers of those increase in laws and stuff during the '70s, '80s, and '90s, but there really wasn't any evidence for either of them - in the '70s and '80s in particular. So most of the research evaluating whether prison actually does deter recidivism has popped up over the last 25 years or so. [00:08:05] Crystal Fincher: And as you took a look at it - all of the studies that have popped up over the past 25 years had varying degrees of rigor and scientific validity. But as that body of research grew, people began to get a better idea of whether incarceration actually does reduce someone's likelihood of reoffending. How big was that body of work, in terms of studies, and what were you able to look at? [00:08:40] Damon Petrich: So in our particular review, we looked at 116 studies, which is a pretty sizable number. Most people - when you read through an article and a literature review might have 10 studies or something that they just narratively go through, but we looked at 116. And then within those 116 studies, there were 981 statistical models. So 901 different comparisons - or 981 different comparisons - of what happens to custodial versus non-custodial groups. So we looked at a pretty big chunk of literature. [00:09:20] Crystal Fincher: And in that, in the reliance of - that's a really big number - and I think, people now are maybe more familiar, just from a layperson's perspective, of just how big that number is. As we've seen throughout this pandemic that we're in the middle of, studies come out - people are looking at one study, and wow - study number two comes out and we're feeling really good about it. And man, we get to five studies and people are like, okay, we know what's going on. To get beyond a hundred is just a real comprehensive body of study and analysis. What were you able to determine from that? [00:10:05] Damon Petrich: So I should probably explain upfront what a meta-analysis is and why it's useful. So like you were just saying - like in the COVID pandemic, for example - one study will come out and it'll say, oh, Ivermectin reduces symptomatic COVID cases by X percent. And then the next study will come out and say, Ivermectin makes people way worse. So any individual study can be kind of misleading. A good analogy for what a meta-analysis does would be to look at baseball, for example. So let's say you're interested in some rookie player that's just come out, he's just joined Major League Baseball and you go to his - you want to know how good this player actually is? You've never seen him play, you've only heard rumors. So you go out to his first game, he gets up to bat four times and he gets no hits. So you walk away from that game thinking, wow, this player is terrible, the team wasted all their money recruiting and paying this guy's salary. But that could have just been an off game for many reasons - it's his debut game so maybe there's just first-game nerves, maybe the weather was bad, maybe he was having personal problems in his life, or he had a little bit of an injury. So there's a number of reasons why looking at his performance from that one game is not going to be representative of who he is as a player. Ideally, you'd want to look at all the games over a season where he might go up to bat 250 times. And over those 250 times, he gets 80 hits, which is a pretty good batting average - it's over .300. So with that amount of data, you could come to a more solid conclusion of whether he's actually a good player or not. And with that amount of data, you could also look at what we call moderating characteristics. So you could look at, for example, whether he plays better when it's an away game or in a home game, whether it's early or late season - you could look at all these sorts of things. So this is essentially what we're doing with research as well, in a meta-analysis. So if you look at studies on incarceration - one might show increases in recidivism after people go to prison, the next might show decreases, and the next might show that probationers and prisoners reoffend at about the same rates. So just like in the baseball analogy, in a meta-analysis, we're looking at all of the available research. We're combining it together and determining A) what the sort of overall or average effect of incarceration is, and then B) whether these moderating characteristics actually matter. So in other words, is the effect of incarceration pretty much the same for males as it is for females, or for juveniles as adults, or when the research design is really good versus when it's not so great. So that's basically what we did in this meta-analysis is again - looked at 116 studies and from those 981 statistical estimates. [00:13:13] Crystal Fincher: Very helpful. Totally makes sense with the baseball analogy, and I especially appreciate breaking down with all the statistical models and not just kind of thumbs up, thumbs down - the binary - it either increases or reduces the likelihood of recidivism. But under what conditions are - might it be more likely, less likely that someone does? What are some of those influencing effects on what happens? And so you were just talking about the justification that people used going into this, and now that we have data coming out - does it turn out that people go into prison or are incarcerated in jail, they think - wow, this is horrible. Some in society are like the more uncomfortable we make it in jail, the better we want to make sure it's a place that they never would want to come back to - that it's so scary and such a bad experience that they are just scared straight for the rest of their lives. Does it actually turn out to be that way? Do they take a rational look at - this was my experience, I don't want to go back again, therefore I will not do any of the things that I did going in. [00:14:28] Damon Petrich: I would not say that's the conclusion - no. So again, based on the 116 studies that we looked at, which is again a lot, people who are sentenced to incarceration - so jail, prison - they commit crime, they reoffend at about the same rates as if you'd sentence those same people to probation. So in other words, they're not being deterred by being sent to prison. These effects are the same for both males and females. So in other words, prison doesn't reduce reoffending for one group versus the other. It's the same whether we look at adults versus juveniles, it's the same regardless of what type of recidivism we're interested in - rearrests or convictions. It's pretty much the same across the board. There's some slight variations in research designs, but even within those, prison either has no effect or it slightly increases recidivism. We don't find any conditions under which prison is reducing reoffending or deterring these people from going back to those lives. [00:15:35] Crystal Fincher: So from a societal perspective, a lot of people kind of make the assumption that, Hey, we arrest and we incarcerate someone - whew, our streets are safer. They get out, and now they can choose to reintegrate themselves into society hopefully - they do and we're all safer because of it. But it looks like impressions that some people may have that, Hey, we're letting someone off easy. And suggestions - there's so much media coverage around this - and suggestions that because we're letting people off easy, that we're making it easier for them to reoffend, or they don't feel sufficiently punished enough and so that becomes an incentive to reoffend. Does that seem like it tracks with what the studies have shown? [00:16:33] Damon Petrich: Not really - so there's some studies that actually ask prisoners and offenders whether they'd prefer going to prison or probation. And a lot of them will say, oh, I'd rather do a year in prison than spend two or three years on probation. So it's not like they view probation as just being super easy. And they're not saying this because they received time off their sentence for being in the study or anything like that. Probation's not easy either - and you have to also think that while these people are on probation, they're able to stay in close touch with their family, they're able to maintain connections with work or find work, they're able to participate in the community, they can pay taxes - that I know a lot of people who are pro-prison love. So there's all sorts of reasons why - beyond just them reoffending at the same rates as if they'd gone to prison - there's a lot of reasons why we might want to keep these people in the community. And it's not like we're saying, let everybody out of prison - so the nature of this research - you want to compare apples to apples. So in this research, comparing prisoners to probationers - these have to be people who are getting - they could either legitimately get a sentence of jail or probation, or prison or probation. So these are going to be first-time offenders, people who are relatively low-level - they've committed low-level crimes and all that. So we're not saying - there's not going to be a situation where a murderer just gets probation - that sort of thing. So I know that might be a concern of some people - they think that's a natural argument of this analysis, but it's really not. [00:18:24] Crystal Fincher: Well, and to your point, we're really talking - if we're looking at all of the crime that gets people sentenced to prison time, a very small percentage of that is murder. A very small percentage of it is on that kind of scale - you can wind up in jail or prison for a wide variety of offenses - many of them, people perceive as relatively minor or that people might be surprised can land you in prison. Or if someone has committed a number of minor offenses, that can stack up - to your point in other situations - and increase the length of detention or the severity of the consequences. As we're looking through this and the conversation of, okay, so, we sentence them, we let them out - it's not looking like there's a difference between jail or community supervisions, things like probation - what is it about jail that is harmful or that is not helpful? What is it about the structure of our current system that doesn't improve recidivism outcomes for people? [00:19:42] Damon Petrich: Probably the main one is the rehabilitation is not the greatest. So just as an example, substance abuse is a very strong predictor whether people are going to reoffend, unsurprisingly. About 50% of prisoners at the state and federal level in The States meet the DSM [Diagnostic and Statistical Manual of Mental Disorders] criteria for having a substance use abuse disorder - so they meet the clinical criteria for substance abuse disorder. So half of them, and then more than that just use substances, but they don't meet the criteria for a disorder. But of that 50% who has a substance abuse disorder, only about 20% of those actually receives treatment for it while they're incarcerated. So, you're not dealing with a root cause of reoffending while they're in prison - so you're not deterring them, but you're also not rehabilitating them - so you're really not doing anything. And then in the rare cases where these people are provided with rehabilitation or reentry programming, it's often not based on any sort of evidence-based model of how you actually change people. So there's a lot of psychological and criminology theory and research on how you actually elicit behavioral change, and these programs really aren't in line with any of that. And I could give examples if you wanted, but - [00:21:17] Crystal Fincher: Sure. I think that's helpful, 'cause I think a lot of people do assume, and sometimes it's been controversial - wow, look at how much they're coddling these prisoners - they have these educational programs, and they get all this drug treatment for free, and if they don't come out fixed then it's their own fault because they have access to all of these treatment resources in prison. Is that the case? [00:21:43] Damon Petrich: No, I wouldn't say so - first of all, they don't have access, a lot of them, to any programs. And then, like I said, the programs that they do get really aren't that effective. So the big one that everybody loves to argue for is providing former inmates with jobs. If you look at any federal funding for program development, like the Second Chance Act or the First Step Act - I think that was one under Trump - and then under Bush, there was a Serious [and] Violent Offenders Reentry Initiative - pretty much all of these federal bills will be heavily focused on just providing offenders with jobs. And almost all of the evaluations of these programs show that they don't reduce reoffending. And it's not really that hard - again, if you go back to the literature on behavioral change and, criminology literature - it's not really that hard to understand why just providing a job isn't going to reduce or lead somebody away from a life of crime. A lot of these people have spotty work histories where they've never had a job at all, they believe and know that it's easier to gain money by doing illicit work than it is legal work, they have things like low self-control so they're very impulsive, they don't know how to take criticism or being told what to do by a boss. They live in neighborhoods with very poor opportunities for good jobs and education, and maybe there's a mindset around there that illegal work or whatever is just a better way to go - that's sort of ingrained. So there's a lot of different reasons why just handing somebody a job isn't going to lead them away from crime, 'cause they have all these other things that need to be dealt with first. So ideally, a rehabilitation program that's comprehensive would deal with all of those other background factors and then provide them with a job. Because if you make them less impulsive, better able to resist the influence of their antisocial friends, and get this thought out of their head that other people are being hostile towards them when they're really not - all these sorts of cognitive and behavioral biases that they have - if you deal with all of those things and then you give them a job, they're more likely to actually latch onto that job as something worthwhile doing. And then they're going to go on to get out of a life of crime. But if you just give them a job and you haven't dealt with any of those issues, you can't really expect that to work. And that is the model that we currently do - is something that we don't really expect to work that well. [00:24:28] Crystal Fincher: Yeah, that's - it's really interesting and I don't know that a lot of people actually know that, Hey, giving someone a job isn't sufficient - which is why I think it's so important to talk about studies like this, because some of what has become conventional wisdom, really is not accurate or reflects what has been studied and discovered. And I guess in that vein, what are the factors - you just talked about a few - but what does increase someone's likelihood of reoffending or recidivism, and what reduces it? [00:25:08] Damon Petrich: So those are probably two ends of the same, or two sides of the same coin, but this is pretty well known in criminology - a model called the risk-need-responsivity [RNR] model was developed by a couple of fellow Canadians, named James Bonta and Don Andrews, along with some of their colleagues in the '80s and '90s. And they, through again, other meta-analyses just like we did, found certain categories of characteristics of people who are more likely to reoffend. So you have things like having antisocial peers - so that one's pretty obvious - if you have a bunch of friends that are involved in crime, it's going to be pretty hard for you to get out of that life because you're surrounded by those people. Same with family members. If you have what are called criminal thinking patterns - so again, you might have what's called a hostile attribution bias, things like that, where somebody says something a little bit negative to you and you take that as a huge insult and you retaliate with anger and aggression - things like that. Or being impulsive - so you're again quick to anger, you're swayed by small little enticements in the environment and that sort of thing - so you're easily swayed one way or the other. Things like that are strong predictors of reoffending. Substance abuse - it's what I mentioned earlier. If you don't really have any sort of proactive leisure activities, like hobbies and stuff like that. So there's a bunch of well-known things that we know are strongly associated with recidivism, and a rehabilitation program should ideally deal with them. Now this model that Andrews and Bonta and all these other people came up with - this RNR risk-need-responsivity model - the risk part says that we should give people a risk assessment when they're entering prison or leaving prison and determine what level of risk are they from reoffending. And we assess these different criteria, like criminal thinking patterns and antisocial friends and substance abuse. So we determine what those factors are and then we design them a treatment program that actually deals with those factors at the individual level. So we're not just giving a blanket rehabilitation program to everybody, and you're providing the most amount of care to the people who most need it or who are the most likely to re-offend. And then once we've done all that, we need to make sure that we're addressing these problems in some sort of a format that we know actually works. The most well-known one, but not as often used, the most well-known within the sort of psychologist and criminological literature is cognitive behavioral therapy [CBT]. So this is pretty popular for dealing with depression and all sorts of eating disorders and substance abuse problems in non-offender populations. Well, those programs also work in offender populations and they work pretty well. So the research shows - again meta-analyses - that when you deal with all these three factors - risk, need, and responsivity - you can reduce reoffending rates by about 26%. So it's a pretty sizeable amount - it's much greater than you're getting by just sentencing people to prison without doing anything. [00:28:42] Crystal Fincher: Absolutely, and I think you cover in your paper - those things are absolutely true. And you just talked about several administrations' attempts to implement programming and resources to try and help people get jobs, potentially - hey, there's even a CBT treatment, but if that treatment has twice as many people as are recommended being in a session and occurs over half the time that it's supposed to, you really are sabotaging the entire process or really setting it up for failure. And it just seems to be an expensive exercise that we aren't really getting anything out of. Does that seem to be consistent with how you've seen the attempts at introducing this programming within prisons and jails? [00:29:40] Damon Petrich: Yeah, for sure - this is a pretty common finding too - so it's not just about preaching that you're going to do these things. You actually have to implement them well. So just like you said, there's a number of studies that show this - so you've designed some really great program that deals with all of these risk factors that lead people back into reoffending, you give it to them in a cognitive behavioral setting. So all seems good on paper, but in practice, like you said - one of the famous studies there - can't remember the names of the authors offhand right now - but one of the famous studies there showed that they're providing it to people in groups of 30, as opposed to 15, and they're delivering it in a really short amount of time. And they're not maybe giving it to the highest-risk people - so they're just mixing random people in there at varying levels of risk. So when you do all these sorts of things - you implement the program poorly - you can't really expect it to work. And this is often the case - is the government pays people to come up with these great programs, and then not enough funding is provided to actually make sure that they're implemented and evaluated well. So the amount of funding that actually goes into that - developing the programs to begin with - is small, but when you do do that, you're not making sure that you're actually implementing things well. So it's just sort of shooting yourself in the foot, and probably making people come to the conclusion that these things don't work - when they do work, if you just implement them well. [00:31:17] Crystal Fincher: Yeah, and there's also a lot of rhetoric - and you discuss this - there's a lot of rhetoric coming from the government, even coming from leadership within the Bureau of Prisons or leadership in our carceral system, saying we do want to rehabilitate people. We are trying to implement programming that does this. You see - we have these educational opportunities and we are doing evaluations of people. And it may be happening while they're understaffed or other challenges, but one of the biggest, I guess, red flags is that none of the evaluation of their programs and none of the incentives that arise are in any way tied to what is the actual result of what happens. Are you actually succeeding on reducing someone's likelihood for reoffense? It does not seem like any compensation is tied to that, any kind of evaluation of positions or regular reporting - to say, is this program having its intended effect? And if not, what do we need to do to correct for that? Is that what you found? [00:32:33] Damon Petrich: I would say that's probably a pretty fair assessment. A lot of the programs that are implemented are never evaluated at all. And then the ones that are - it's usually once - there's one evaluation of those programs. And then, like you said, there doesn't really seem to be a lot of self-reflection - I don't know what other word you would use - but these programs don't really change on the basis of these evaluations. So, it's kind of disheartening to hear about, I guess. [00:33:14] Crystal Fincher: It feels very disheartening to live in the middle of - and one of the big things about this is that this - we have these conversations and we talk about these studies and we're saying, yeah, it actually - we're not doing anyone any favors right now when it comes to reducing recidivism. And having these conversations oftentimes detached from the cost associated with what we're paying for these. And my goodness are we paying to incarcerate people? It's not just, well, we do lock them up and we keep them away. Or we do a good job of keeping them in - they reoffend, they go back to jail. And lots of people are like, we did our job, they went back to jail - boom, everything is fine. But we are paying through the nose and out the ear for this - just here, we're in the state of Washington, and right now the state spends about $112 per day, or over $40,000 annually, to incarcerate one individual - that's the cost per inmate. In King County - the county that we're in - they spend $192 a day, or $70,000 annually, to incarcerate an individual. That is a huge amount of the tax dollars that we spend - these come out of our general fund, meaning that these are dollars that every service, everything that is not a dedicated source of revenue, is competing for. So when we talk about things and have conversations like, well, we don't have the budget for that and we don't have the money - that is related to how much of that money we're spending on other things. And my goodness, I would think that we want to get our money's worth for that level of expenditure. And it really appears that if we're saying the goal of jail is to get people on the straight and narrow path and becoming contributing members of society and all of the implications of that, it doesn't seem like we're getting our money's worth. And so, if those aren't the goals and if we just want to punish people, it's not like we're punishing people for free. We're punishing people at the cost of $70,000 per day [year], and at the cost of all the other services and infrastructure needs that we have. So it really seems like we're punishing ourselves as much, or more, as others - particularly if we're bringing people back into society that are likely to reoffend in one way or another. And so if our goal is to keep our community safe and that is the North Star, it looks like we need to realign our processes and our expenditure of resources. I guess my question to you, after all that, is - how should we be moving forward? What should we be looking to do? What is shown to work? [00:36:24] Damon Petrich: Well, I would say - yeah, $70,000 a year as just a revenge cost per person seems like a lot. $80 billion in the country as a whole, for a revenge cost, seems like a pretty high price to pay, given we're not reducing reoffending. You could make the argument that these people aren't offending while they're in prison, but that's - there's other reasons why that might not be completely accurate, which I could talk about too, but - [00:36:59] Crystal Fincher: Well, I'm interested in that. Why might that not be accurate? [00:37:03] Damon Petrich: So, obviously the person - if you incarcerate a particular individual, obviously they can't be out in the community committing crimes. So that's obvious, but there's a number of reasons why that might not, en masse, actually reduce crime a whole lot. The research on it - this is a little bit squishy - in terms of whether incarcerating more people leads to lower crime rates, because one influences the other. But for example, if you look at illegal drug markets - a lot of the homicides in the United States and other violent crime that people are really concerned about, and it's plastered all over the media is - homicides, gang-related stuff. So if you take key gang members out and you put them in prison, what ends up happening is that there's competition in that market to take over that person's place, either within the gang or other gangs coming in. So what ends up happening oftentimes is a spike in violence. So that's one reason why just incapacitating, particularly high-crime individuals, might not actually lead to lower crime rates overall. Again, you're lowering crime for that one person, but you might be increasing crime on a more systemic level. Beyond that, these things have broader societal and community level impacts - incarcerating a lot of people. Again, research shows that when you're incarcerating a lot of people in a particular community - so there's a bunch of really good work by Robert Sampson - he has a book that came out a few years ago called Great American City. And he looked at these individual neighborhoods in Chicago over time, and what he finds is that in communities where there's a higher number of people incarcerated in a particular community, this ends up increasing what's called "legal cynicism." And this is done in some other work as well with David Kirk and Andrew Papachristos - but they show that this increases legal cynicism, which means people are skeptical of police helping them out, the police doing a good job. And what ends up happening after that - when people are more cynical of the legal system, they're less likely to report crimes to the police, they're less likely to cooperate with the police. So what ends up happening? You incarcerate more people and people in that community end up being less willing to cooperate with law enforcement. And this leads to sort of an endless cycle where things sort of get out of hand. So there's all these unintended and nonfinancial consequences of incarcerating a lot of people that could potentially end up leading to more crime. [00:40:03] Crystal Fincher: Well, and - speaking as a Black woman - obviously, looking at the impacts of mass incarceration in the Black community and in neighborhoods around the country - where it is almost like the community is responding to the actual outcome and that, Hey, this actually isn't making my community any better. I'm experiencing traumatic impacts from this - whether it's my relative went to prison or a sole breadwinner in the family and now we're thrown into poverty, or I'm in a situation where I don't have a parent who used to be there - who now is no longer there. Or causing instability and impacting the education that people get and the kind of job opportunity, watching someone who's come out have to struggle and be ostracized. And it looks like, Hey, this is just the first step on a long cycle of traumatic and undesirable events - and I don't want to participate in a system that is doing that. With that, as we look forward, and I think this is also related to conversations about just fundamental trust in our criminal legal system and relations with police and throughout the system. It's - if we think about how to turn that around - to me, seems related to thinking about the question of how do we get better outcomes for everyone? 'Cause it seems like right now where we're investing a lot in poor outcomes for people who were already, usually, in pretty poor spots leading to themselves being incarcerated, coming out and not necessarily improving, definitely not improving. And if anything, a chance that it gets a little bit worse. How do we change that entire outcome? And I know you're looking specifically in the incarceration space, but what should be, what could be done differently? Or do we just need a fundamental restructuring of the way we do this? [00:42:17] Damon Petrich: I don't know about a fundamental restructuring - I don't, I'm not great at that high-level thinking stuff, but what I do know is that - we're probably going to continue to incarcerate people. That's something that's done in every country and people seem to love here. So if we actually want to use prison for public safety - because 95% of inmates eventually get out - if we actually want to use it for public safety, then let's actually try wholeheartedly to rehabilitate them while they're in there. And again, there's a lot of theory and evidence-based principles on how we can do this, like the risk-need-responsivity model that I talked about earlier, cognitive behavioral therapy more broadly. If you use these types of things and continue to work on them and develop them over time, then yeah - prison might actually be helpful if people are going there and getting the help that they need. But that's not what's happening currently. So that's one level in incarceration terms - that's the area that I know best. So that's one way you could potentially alleviate some of this stuff is - if people are actually getting resources and stuff when they're in prison, and then when once they're reintegrating, they're not only going to reoffend less, but maybe they're going to contribute to their community more. They're going to be better able to connect with their family and stuff like that. So rather than being a hindrance, it could potentially be a help. Obviously, again, it's not ideal to remove people from their communities and their family and friends. And like I said earlier, if you have the option to sentence them to something community-based instead, I think that's the better route to go. But if you are going to send people to prison, which I think we're going to continue to do a lot of the time, then let's rehabilitate them while they're in there is the main point. And do so based on what actually works to do that. [00:44:23] Crystal Fincher: It's really the investment in the people who are there, and we're - I think up against a lot of societal attitudes and resistance where it just feels wrong to a number of people to be providing services and shifting that investment to things that are seemingly helpful for the inmate, because everything about how we've been conditioned to understand our prison system has been - the punishment is kind of the key, and they'll make rational decisions afterwards to avoid prison based on how bad the punishment is. When it comes to community supervision, things like probation, what are the differences there? If there are better outcomes from that, what accounts for the better outcomes when it comes to probation versus incarceration? [00:45:23] Damon Petrich: I wouldn't say the outcomes are better - they're just pretty much the same as they would be if they're sentenced to prison. So, probation costs less and then it also enables the people to be out in the community doing community things, like being with their friends and families and all that. I mean, you can't quantify, based on a recidivism percentage, what their family members and friends and employers are getting out of it. So that's something we can't really look at - or I guess you could, but something we don't often do - but so there's intangible things that you would get by keeping people in the community. Plus it doesn't lead to all that other stuff I talked about where people become cynical of the legal system and it leads to this cycle of whatever. [00:46:11] Crystal Fincher: Yeah, and so if we're were doing this programming in prison and helping people, I think your research shows it's extremely important to do both the structural, Hey, you need a place to live, you need to be able to pay your rent and your bills - so having a job, having housing, having healthcare, getting those very basic needs met is critical. But also addressing a number of the mental or behavioral health issues that are common among the incarcerated population - and dealing with that is as important. And basically those two things both need to happen hand-in-hand. How do we do a better job of that in our current system? [00:46:57] Damon Petrich: Well, first of all, I'd like to say that you're right there - I think maybe when I was talking earlier about employment, it might sound like giving people jobs is just a waste of time, but that's not the case. It needs - the two things need to be paired - you need to deal with the cognitive and behavioral problems in addition to giving them jobs and housing support and all that. In terms of how you actually go about doing that, there are examples in the literature of programs that do this, so there's examples out there. I think if you're a state or local or even federal correctional department and you're interested in doing this - implementing something that's evidence-based - or if you're just a concerned citizen that wants to rally your local officials to do that - go and talk to researchers like me, or people at universities that have criminology departments or criminal justice departments, because this knowledge is out there. It's widely available. You just have to go and seek it out. So at my university, for example, we have the University of Cincinnati Corrections Institute and under the guidance of Ed Latessa, he was - now passed - but he was, over the last 30 years, responsible for disseminating a lot of this evidence-based practices to some of the state and local criminal justice agencies. And they helped with implementation and evaluation in a lot of these places, so the help is out there. You just have to look for it a little bit. [00:48:38] Crystal Fincher: And another question I had - your analysis seemed to suggest that when we're talking about low-risk, medium, and high-risk offenders - or people who have done relatively minor crimes versus those who have done more serious crimes - that these interventions are particularly effective the more serious the offense or crime has been. And that perhaps even sometimes treating someone who is a really low-risk as if they're a high-risk, can worsen the outcomes for that person. Is that the case? [00:49:21] Damon Petrich: Yeah, that tends to be a finding in research - we're not exactly sure why, but providing a lot of really intensive services to people deemed to be low-risk can actually be harmful rather than helpful. We don't know based on research why, but there's a lot of pretty good hypotheses about why. So a low-risk offender is going to be somebody who's a first-timer who's committed some not-that-serious crime. So they probably have a job, they probably have pretty strong connections with their family and all that. So if you're taking them and you're putting them in a program where you have to be there 40 hours a week, they're probably going to get fired from their job, it's going to be harder to stay in contact with friends and families that are sort of tying you into a non-criminal life. And then you're probably going to be associating with all kinds of people who are high-risk, and maybe they're going to draw you towards, oh yeah, I could earn four grand going out tonight and stealing some laptops. There's a lot of reasons why just taking low-risk people and putting them in these programs is going to be harmful rather than helpful. [00:50:31] Crystal Fincher: And so with that in mind, and you talk about, Hey, if we're trying to influence local electeds - one of the interesting things about having a podcast and radio show that caters to extremely politically and civically inclined people is that we actually do have a number of policymakers and politicians who listen, and people who are enacting and in control of this policy. If you were to talk to them and give them advice about how to move forward, especially in the current environment that we find ourselves in, where over the past few years has been increasing awareness of some of the defecits of our system and pushes to change those. And also, as we have seen more recently, a real strong pushback from a lot of people who are invested in our current system saying, Hey, let's not change things too much. Maybe we need to jail more and for longer. And maybe we're just not doing enough incarceration, and that's the answer. In that kind of political environment, what would you tell people who are in charge of this policy, who may be facing pressure to keep going forward with the status quo, about how they should evaluate how they should move forward and the kinds of things that they should do? [00:52:07] Damon Petrich: I know a lot of these politicians get lobbied by correctional officer groups or whatever, and that's whatever, but ultimately you get voted in by voters. So, I'm not an expert on public opinion - I have other friends who are more into that kind of stuff, but I do know from talking with them and from reading that literature, that the public actually does support rehabilitation. So they have for a long time and it's shifted more towards being in support of rehabilitation over time. So right now, most Americans support providing rehabilitation programs to prisoners and offenders. So this is something that's going to please your constituency, people want this kind of thing. And it's not like you're going to be losing all kinds of jobs by getting rid of prison - there's going to be a need for skilled people who can provide these programs and probation officers and all these sorts of things. So it's not a net loss when you're getting rid of prisons. There's a lot of reasons to sentence people to community supervision and things like that - provide rehabilitation. There's public support for it, there's jobs involved, there's cost savings - big time, obviously - it's way cheaper to keep somebody out of prison than it is to keep them in prison. So there's a lot of different reasons why you would want to do that as a politician. [00:53:43] Crystal Fincher: I think that makes sense. Certainly it's a lot cheaper to keep someone out of prison versus in prison. I mean, we talked about the annual costs - in the state of Washington over $40,000, King County over $70,000 - comparing that to how much we invest in a student of $11,500 a year. If we focus more on investing in people, both inside and outside the system, it seems like we set ourselves up for a safer community, fewer people being victimized, and more people leading thriving, productive, tax-paying lives. And we're all happier than we are right now, I would think, I would hope - it seems like the research points in that direction. So I certainly appreciate you taking the time to speak with us about this. Is there anything else that you want to leave with us, in thinking about this study and your research? [00:54:55] Damon Petrich: I think we covered it pretty well. Just to circle back to something you just said - I know this might put me out of a job since I focus on what happens when people's lives go awry, but you really are better off to invest in early prevention programs and giving people a good start on life than trying to correct the program or the problem afterwards. So yeah - politicians spend some money on prevention programs. I know the good effects of that are a long way out, but they're actually good on a societal level. So I guess I would add that, even though it's not good for criminologists, maybe, to put themselves out of a job like that. [00:55:40] Crystal Fincher: Well, much appreciated, and thank you so much for having this conversation with us today. [00:55:45] Damon Petrich: Yeah, thank you very much for having me on. I'm glad that there are people out there interested in this stuff, so thanks again. [00:55:51] Crystal Fincher: I thank you all for listening to Hacks & Wonks on KVRU 105.7 FM. The producer of Hacks & Wonks is Lisl Stadler with assistance from Shannon Cheng. You can find me on Twitter @finchfrii, spelled F-I-N-C-H-F-R-I-I. Now you can follow Hacks & Wonks on iTunes, Spotify, or wherever else you get your podcasts - just type "Hacks and Wonks" into the search bar. Be sure to subscribe to get our Friday almost-live shows and our midweek show delivered to your podcast feed. If you like us, leave a review wherever you listen to Hacks & Wonks. You can also get a full transcript of this episode and links to the resources referenced in the show at officialhacksandwonks.com and in the episode notes. Thanks for tuning in - we'll talk to you next time.

Narcissistic Personality Disorder is a diagnosis in the DSM (Diagnostic and Statistical Manual of Mental Disorders) NPD is considered a disorder more commonly found in men than women in which a person has: An inflated sense of self-importance Symptoms include an excessive need for admiration Disregard for others feelings, i.e.,  lack of empathy The inability to handle criticism An overwhelming sense of entitlement. While this disorder is overwhemingly found in men, women can be narcissist too! Key Takeaways/Red Flags: Look at the speed of the relationship. i.e. doing wayy too much, wayy too fast! Love Bombing: An attempt to influence a person by grand demonstrations of attention and affection.  Sob/victim stories They mirror your behavior identically, i.e.,  EVERYTHINGyou like they like.. Be aware of the narcissist/manipulators favorite tool to keep your around:  F.O.G. - F.ear O.bligation G.uilt Manipulative people are experts at gaslighting,i.e. , making you question your reality AND they're really good at getting you to ignore your intuition/gut-feelings If you're in a toxic/abusive/narcissistic relationship and want to get out please know there's help & hope! Make a detailed plan to leave including: Gathering your tribe! Get your emotional support team together! Get everything in place. The moving truck, where are you going to go? How much money do you need to leave? Can you access your money? Make sure you have a place to go. And your abuser doesn't know where that place is. ABSOLUTLEY No contact! Change your number. Get off of social media. Do not give them a window to anything that you are doing. As far as they are concerned, you do not exist. Change all your passwords to every account, social media, email, bank accounts.. ALL OF THEM! If you have children together: Make sure you have, preemptively reached out to an attorney and know the laws, because if you go missing in the middle of the night with the children, they're going to accuse you of kidnapping and you don't want to get in any legal trouble. Make sure you secure any important documents like birth certificates, social security cards, anything of value. Get ahold of it now because if they get it they will destroy anything that is important to you. Be prepared to co-parent with boundaries & supervision.  Document everything because documentation is power! Be prepared to go through hell in the court system. Narcissistic/emotional abuse if still not widely considered a real form of abuse The Other Side - Your Glow Up! Your healing will stop the cycles attracting abusive people into your life. Implement your highest level of self love; loving all of you, the good, the bad, the ugly! Forgive him/her, forgive the past, forgive yourself! Speak your truth without apologizing, without  guilt, without shame, without  blame and trust the process. Trust yourself & your intuition! Say yes when you mean, yes! Say no when you mean no! You can heal from these experiences, and you find true love. Be kind and patient with yourself during this time There's nothing that you did wrong. There's nothing wrong with you. You're not damaged. You're not broken. You simply have unhealed wounds and wounds heal with time! Real love doesn't hurt...!! Do not be afraid to connect and find a support system with other survivors & thrivers! Loving, living and honoring your most authentic self is so important! For help, resources and a community of healing and support, my very special guests this evening were: Denise Kavaliauskas,Transformational Love Coach, Speaker & International Best Selling Author: https://trueloveaftertoxiclove.com/ IG: https://www.instagram.com/lifeafternarcissism_111/ FB: https://www.facebook.com/denise.clarke.758/ YouTube: https://www.youtube.com/channel/UCYmjngJD5iL0j4yKZ9SywQw Kim Carpenter, 3rd generation Intuitive & Certified Mindset Coach: https://www.bimberlynnsoulworks.com IG: https://www.instagram.com/iamintuitive_kim FB: https://www.facebook.com/bimberlynn LinkedIn: https://www.linkedin.com/in/iamintuitivekim SJ, "Le Disco Mama": Survivor, Thriver, Host of "Drama at the Disco" Podcast & Narcissistic Abuse Advocate: beacons.ai/le_disco_mama Drama At The Disco- Podcast IG: https://www.instagram.com/le_disco_mama/ YouTube: https://www.youtube.com/channel/UCr4x0ihrn8sKTWWe2VQDWMQ/featured TikTok: https://www.tiktok.com/@le_disco_mama   Intro Music: "Welcome to The Kandid Shop" - Buss_TE Outro Music: "Until it's Over" - Spring Gang  

Dr. Zucker is a registered clinical psychologist in Ontario. He received his Ph.D. at the University of Toronto in Developmental Psychology in 1982. He is a Professor (Status Only) in the Department of Psychiatry, University of Toronto, and in private practice. He was the Chair of the 2013 DSM-5 Work Group on Sexual and Gender Identity Disorders. He is a past President of the International Academy of Sex Research and has been the Editor of Archives of Sexual Behavior since 2002. Since 1976, Dr. Zucker has worked clinically with children and adolescents with gender dysphoria and their families. His research spans a variety of areas, including epidemiology, diagnosis, and assessment, associated mental health challenges, causal mechanisms, and long-term follow-up.   In our discussion, Ken describes the early years of working with childhood gender issues starting in the 1970s. We talk about the changes he's seen in the kinds of kids, families, and therapists in the field. Politics has always been present in the world of gender identity treatment, but this came to a head for Ken when he was fired from his position at the CAMH hospital in Toronto 2015 after activists made some wild accusations and hospital administrators became fearful for their positions. After a three-year legal battle, he was finally vindicated and compensated. Even with his decades of leadership in the field, Zucker was not protected from this early cancel-culture manifestation. We talk about what his story means for individuals in practice and the field more broadly. Links: Dr. Zucker's Website:  https://www.kenzuckerphd.com/ (Kenzuckerphd.com)   Sexual Identity Conflict in Children and Adults:  https://www.amazon.com/Sexual-Identity-Conflict-Children-Adults/dp/071560774X (Amazon.com/Sexual-Identity-Conflict-Children-Adults/dp/071560774X) Extended Notes Ken talks about how he accidentally got into the studies of gender identity disorders. He shares about when he met Sue Bradley and joined her gender identity clinic for children and adolescents at the Clark Institute of Psychiatry in Toronto that she just started in the early '70s. What was it like working with this study, it being taboo at the time? Ken also talks about the parents that brought their children to their clinics. What led them to seek help? Anxiety about sexual orientation is still an issue that many parents struggle with. Ken shares the shift in focus of their research studies from the '70s to the early 2000s between children and adolescents. How much impact do social media and the internet have with rapid onset gender dysphoria? Ken also shares his insights on this. Ken talks about his experience and the various views of the subcommittees within the DSM (Diagnostic and Statistical Manual of Mental Disorders) during his involvement with them. Ken gets into more details when their clinic got closed in 2015, being one of the early targets of cancel culture. With newer administrative heads in their child program, the criticisms they received in 2015 would have been taken differently if it was still managed with Sue Bradley and their former bosses. Ken shares what were his thoughts at this time. Did he think that his career would be ruined thereafter? Ken also talks more about the lawsuits he then filed against newspapers, the hospital, and one of the administrators of their program due to libelous comments and defamation, among other things. People being accused of things and these things going viral get them canceled as opposed to having an exchange of ideas has become a pervasive issue in the last years. Ken also shares his interactions with both new and old colleagues and how they fear for their jobs if they don't adhere to a particular point of view. The consequence of the legal issues and politics within this field is terrorizing clinicians from wanting to work with this population. Following his pursuit, clinicians are now pushing back and taking Support this podcast

Is psychiatry doing more harm then good? In this episode, our guest speaker Nick Fortino who is a psychology professor at University of Silicon Valley and Gavilan College in the USA, talks to me about the nature of mental health diagnosis and how it's history evolved into what we know today as biological mental disorders. We cover the history of the DSM (Diagnostic and Statistical Manual of Mental Disorders), classifications of disease and the efficacy of psychiatric drugs for conditions like depression, anxiety and more. 

Today René Brooks is joined by Shannon Russell for a conversation about creating change in the mental health community. The pair talk about the pitfalls of black and white thinking when it comes to ADHD and identify many of the gray areas that exist.  From the the good and bad aspects of the DSM (Diagnostic and Statistical Manual of Mental Disorders) to the quest for a new name for ADHD, René and Shannon cover a lot of ground in today's episode; including why you shouldn't get all of your facts from Twitter or TikTok, and the importance of remembering that we're all still learning about ADHD.   You can find Shannon on Twitter HERE or with the username @3TrackMind79, and on TikTok HERE.  Do you have a question or show idea you'd like René to address in a future episode or an episode idea for us? Write an email or record a voice memo and send it to connect@distractionpodcast.com.   We want to hear from you! CLICK HERE TO TAKE OUR LISTENER SURVEY. Distraction is sponsored by Landmark College in Putney, Vermont.  It's the college for students who learn differently! Landmark offers comprehensive supports for students with ADHD and other learning differences, both on campus and online. Virtual Open Houses at Landmark College are scheduled for December 15th, 2021 and January 7th, 2022. Learn more HERE! René Brooks is guest-hosting Distraction through December! René is an ADHD coach, writer and advocate who also has ADHD herself. From Black Girl, Lost Keys website: René Brooks is a late-life ADHD success story. After being diagnosed 3 times as a child (7, 11 and 25) she was finally able to get the treatment she deserved. René decided that her passion for helping others should be put toward people with this disorder who are struggling in silence or shame. She started Black Girl, Lost Keys to empower Black women with ADHD and show them how to live well with the condition. 

Have you been diagnosed with ADD or ADHD? Have you taken medications like methylphenolate? Is Ritalin an amphetamine-like substance? Do these drugs cause brain damage? Is the DSM/Diagnostic and Statistical Manual a medical textbook or a spell book? Tane Webster, ADD expert and owner of Grow Sanctuary, shares his experience of being diagnosed with a behavioral disorder, his journey on the medications and how he healed. He shares his philosophy on the diagnosis and answers an extensive list of Q&A questions at the end of the show.  Show Resources Tane's Instagram: https://www.instagram.com/growsanctuary/?hl=en Tane's YouTube: https://www.youtube.com/channel/UCuH7dYnKqR7bLKF96aqUvvQ http://www.ritalindeath.com/Content.htm https://www.institute4learning.com/2019/08/29/17-reasons-why-i-believe-adhd-is-not-a-legitimate-medical-disorder/ https://www.madinamerica.com/author/mcorrigan/ https://www.youtube.com/watch?v=Ia6OGEj6wW0 https://www.bitchute.com/video/7PBsvmhIRYU/ https://www.bitchute.com/video/tMaiIHc5yGwF/ - best documentary on "ADHD" https://breggin.com/?s=adhd - one of the best authors on "ADHD" https://www.youtube.com/watch?v=gjb1XuyEd5k - my other interview on "ADHD" https://www.youtube.com/watch?v=gigZD4RIXhg My website: www.matt-blackburn.com Mitolife products: www.mitolife.co Music by George Henner https://georgehenner.bandcamp.com

Leslie Cohen talks about her new must-read memoir “The Audacity of a Kiss: Love, Art and Liberation” with Emmy Winner Charlotte Robinson host of OUTTAKE VOICES™ that's published by Rutgers University Press. This is an important read that tells the historic love story of a gay woman who broke through the oppressive roles expected for women in the 1950's and 1960's and came out on top in the 1970's. Not only for women but remember in the 1950's being LGBTQ was illegal and listed as an illness by the DSM (Diagnostic and Statistical Manual of Mental Disorders). It was not until 1973 that the American Psychiatric Association (APA) finally removed the diagnosis of “homosexuality” from the second edition of its Diagnostic and Statistical Manual (DSM). It was at this time that Cohen with three of her friends Michelle Florea, Linda Goldfarb and Barbara Russo created New York City's first upscale women's club Sahara that showcased women in art, politics and music. From May of 1976 to December of 1979 on Manhattan's fashionable Upper East Side Sahara was the first club fronted by lesbian women instead of being controlled by Mafia Bosses. Creating a safe space for women attracted many celebrities and luminaries of the era including Betty Friedan, Gloria Steinem, Pat Benatar, Ntozake Shange, Rita Mae Brown, Adrienne Rich, Patti Smith, Bella Abzug, Jane Fonda to name a few who performed and held special events at Sahara. This led to Leslie and her partner Beth Suskin becoming the models in 1979 for the iconic sculpture “Gay Liberation” in Greenwich Village that commemorates the Stonewall Riots and was declared a national monument by President Obama in 2016. We talked to Leslie about how Sahara changed the course of her life and her spin on the future of our LGBTQ civil rights.  Leslie Cohen has been a museum curator, a nightclub owner and promoter, a limousine driver and a lawyer, as well as a writer whose work has appeared in such publications as Curve and The New York Times Style Magazine. Now retired she and her wife Beth live in Miami, Florida with their cat Birdie. For More Info… LISTEN: 500+ LGBTQ Chats @OUTTAKE VOICES 

Happy LGBTQ+ History Month! Dr. Charles Silverstein talks about his 1973 presentation before the American Psychiatric Association that led to the removal of homosexuality from the list of mental illnesses in the DSM (Diagnostic and Statistical Manual). He also talks about working with the Gay Activist Alliance in the '70s, his landmark book. The Joy of Gay Sex, and how his relationship to sex has changed now that he's 86-years-old. The new documentary, CURED, premieres on PBS on October 11th. You can listen to our interview with the legendary trans elder, Miss Major Griffin-Gracy here: bit.ly/missmajor1 LGBTQ&A is hosted by Jeffrey Masters and produced by The Advocate magazine, in partnership with GLAAD. Come find us on Twitter to recommend a future guest: @lgbtqpod.

When a loved one dies, the world can become chaos. Everything has changed. The way you drive a car, the way food tastes, the way you even talk to people can feel different and wrong and weird. It feels like you are - for lack of a better term - going crazy. How far apart are grief and mental illness? The DSM (Diagnostic and Statistical Manual), the standard reference for mental illness, says that if you're still messed up from grief six months after the death of your person, you have something called Prolonged Grief Disorder.For Megan Devine, an author and psychotherapist who specializes in grief, the sudden loss of her partner Matt meant being at the grocery store and temporarily forgetting how money worked. But she says that's not a problem. That's a truthful response to a horrifying event. That's just being horrified.Megan rejects the idea that being upset for as long as you need to be is a problem. She advocates recognizing the personal truth and reality of what's going on inside yourself. Megan's website Refuge in Grief - https://refugeingrief.com/Our previous episode with Stephanie Wittels Wachs, which gets referenced a lot - https://maximumfun.org/episodes/depresh-mode/stephanie-wittels-wachs-and-the-pain-and-frustration-of-watching-addiction-happen/Get your copy of Megan's books, How to Carry What Can't be Fixed: A Journal for Grief and It's OK That You're Not OK here or wherever books are sold. Follow Megan on Twitter @refugeingrief and on Instagram @refugeingrief.Thank you to all our listeners who support the show as monthly members of Maximum Fun. Hey, remember, you're part of Depresh Mode and we want to hear what you want to hear about. What guests and issues would you like to have covered in a future episode? Write us at depreshmode@maximumfun.org.Help is available right away.The National Suicide Prevention Lifeline: 1-800-273-8255, 1-800-273-TALKCrisis Text Line: Text HOME to 741741.International suicide hotline numbers available here: https://www.opencounseling.com/suicide-hotlinesThe Depresh Mode newsletter is available twice a week. Subscribe for free and stay up to date on the show and mental health issues. https://johnmoe.substack.com/John's acclaimed memoir, The Hilarious World of Depression, is available here. https://read.macmillan.com/lp/the-hilarious-world-of-depression/Find the show on Twitter @depreshpod and Instagram @depreshpod.John is on Twitter @johnmoe.

The DSM (Diagnostic and Statistical Manal) has very specific guidelines on what behaviors can be labeled "addictive". We break that down and discuss the reasons behind addictions developing and the ramifications. Our email: mentalhealthpod21@gmail.com Music by AudioLounge  - Like us on Facebook: www.facebook.com/audioloungemusic - Soundcloud: @audiolounge1 - Youtube: www.youtube.com/user/AudioInstrumentals - Twitter: @audio_lounge - Google+ goo.gl/toKclZ    

Jörgen Herlofson är läkare, specialist i psykiatri, psykoterapeut och även ansvarig utgivare för DSM (Diagnostic and Statistical Manual of Mental Disorders) på svenska. Samtalet med SFIMHs ordförande Leena K Nygren kretsar kring frågor hur det står till med psykiatrin i Sverige, Evidence-based medicin och hur sokratiska dialoger kan ha med detta att göra. Med det som utgångspunkt berörs viktiga områden som manualstyrning, riktlinjer, livsstilsförändringar i relation till psykisk ohälsa och hur en manualstyrd vårdapparat kan skapa passiva vårdtagare. Ett möte mellan begreppen personcentrerande vård och Integrativ medicin och hälsa. Tack för att just du lyssnar på ”Både och, istället för antingen eller – en podd om Integrativ medicin och hälsa. Följ oss på sociala medier, och ge oss gärna fem stjärnor på iTunes om det här var givande för dig. Prenumerera gärna på vår podd! ♥ Facebook: https://www.facebook.com/integrativmedicin ♥ Youtube: https://www.youtube.com/user/integrativMedicin

Jakson teemana on psykiatrian sekä mielenterveyden ja mielen sairauksien diagnosoinnin historia. Selvitämme, miten hulluuden leimasta ja henkiopeista on siirrytty kohti toisaalta pirstaloitunutta ja toisaalta äärimmäisen säänneltyä modernia psykiatriaa. Kuinka kauan mielenterveydestä on puhuttu? Mitkä ovat mielenterveyden ja mielen sairauksien historialliset rajat? Jakson tärkeimpänä oppina on, että mielenterveyden häiriöt eivät ole luonteeltaan vain biologisia tai vain sosiaalisia, vaan monimuotoisia kokonaisuuksia, joiden määritelmät muuttuvat ajasta ja paikasta riippuen. Lähestymme aihetta Yhdysvalloissa alkujaan kehitettyjen DSM (Diagnostic and Statistical Manual of Mental Disorders) -oppaiden näkökulmasta. Ovatko oppaat ratkaisseet mielenterveyden häiriöiden määrittelyn ongelman? Vieraaksi sain Helsingin yliopiston väitöskirjatutkija Mia Pohtolan, joka on kiinnostunut psykiatrian ja mielenterveyteen liitettyjen sairauksien diagnostiikasta Yhdysvaltain kontekstissa 1970-luvulla. Lue lisää lisää jaksosta osoitteessa lottavuorio.com !Read more #33 Mielenterveyden rajoja ja psykiatrisen diagnostiikan historiaa →

Vad är egentligen autism? Finns det olika former? Är det skillnad mellan könen? Hur ställer man en diagnos? Varför upptäcks allt fler? Hur ser det ut i andra länder? Malin Bergström, barnhälsovårdspsykolog, samtalar digitalt med Sebastian Lundström, psykolog och forskare på Gillbergcentrum vid Göteborgs universitet. Ordlista till avsnittet: * Etiologi är läran om orsakssamband eller kausalitet. Termen används inom filosofi, fysik, psykologi, statistik och biologi då man diskuterar orsaker till olika fenomen. Inom medicin används termen specifikt för anledningar och bakomliggande variabler till sjukdomar och patologiska tillstånd. * Prevalens är en epidemiologisk term som anger den andel individer i en population som har en given sjukdom eller ett givet tillstånd. * DSM - Diagnostic and Statistical Manual of mental disorders, är tillsammans med WHOs ICD-system, International Statistical Classification of Diseases and Related Health Problems, det mest utbredda systemet för att kategoriska psykiatriska sjukdomar och tillstånd. Läs mer: * Göteborgs universitet: Sebastian Lundström (https://www.gu.se/om-universitetet/hitta-person/511f2edf-3623-42d7-bc39-c21720819e88) * Göteborgs universitet: Gillbergcentrum (https://www.gu.se/gnc) Special Guest: Sebastian Lundström.

Yvette Stone, psychotherapist and dv advocate. She has her own private practice and is an affiliate and trainer at NW Family Life.During covid she graduated from grad school and started her own practice. It's been a season of “Grief and Gratitude.” When people ask “How are you doing?” For the first time in my life I stop and say, “I don't know.” It's complex and we're all carry so much. There aren't straight forward answers.She works mostly with women in domestic violence relationships and her specialization is with people of narcissistic abuse. Yvette is a survivor herself of narcissistic abuse.Yvette is passionate about bringing narcissistic abuse into the forefront of domestic violence. Most people associate domestic violence with battery—broken bones and hospitalizations—and it is absolutely a category of dv, but psychological and narcissistic abuse also falls under that umbrella and Yvette says it is equally damaging and so much more prevalent than people realize.Maggie asks Yvette to give a formal definition to the term narcissist. Many people use the term casually for someone who is selfish but there is really more to it.Yvette acknowledges that the term has been thrown around a lot more lately. The statics say Narcissists make up 1 in 30 of the US population of those over 60 years old. However that number jumps to 1 in 10 of 20-somethings experience the clinical symptoms of Narcissistic Personality Disorder. She says this is because of the prevalence of violence, materialism and social media (the sense of look at me! look at me! look at me!”) in our culture.She says there is a way narcissistic people will feel to you and then there is the clinical definition. A narcissist is identifiable by their:Lack of empathy for othersInflated sense of importanceDeep need for excessive attention and admirationPerpetually troubled relationshipsThe traits of a narcissist according to the DSM (Diagnostic and Statistical Manual of Mental Disorders):grandiose sense of self-importancepreoccupation with fantasies of unlimited success, power, brilliance, beauty, ideal lovebelief they're special and unique and can only be understood by, or should associate with, other special or high-status people or institutions,need for excessive admiration sense of entitlement,interpersonally exploitative behavior,lack of empathy,envy of others or a belief that others are envious of them,and demonstration of arrogant and haughty behaviors or attitudes.Vulnerable or Deflated Narcissists tend to be a product of neglectful parenting, where as the grandiose narcissists tend to be a product of being spoiled and told how special or entitled

Los trastornos mentales son una realidad con la que convivimos y la literatura no está exenta de ellos. En este episodio hablaremos un poco sobre el DSM (Diagnostic and Statistical Manual of Mental Disorders) y como este se representa en los libros.

This is a summary of today’s podcast on Signs of stress and signs of PTSD. We will start with: Definition of PTSD How pervasive is PTSD in on Americans? Discussion of PTSD affects Examples of events that you choose if you think they meet the definition of PTSD My story A new type of traumatic stress possible being created by the pandemic Effective Treatment options Let’s get started with definition of Post-Traumatic Stress Disorder PTSD Core issues are anxiety and depression, lack of trust, Victim thinking and avoidance. It seems like Trouble or bad things follows me and just happens to me.  I told my story of a life with PTSD memory of a young child whose older brother tried to smother hand and drown me.  I thought I might die. 95% of our mind are was wired by the time we are 18 yo to the beliefs of the parents and environment.  I found a counselor saved my life from a life with an alcoholic fishermen husband from Maine and desperate to live a better, healthier life. That was why I choose to become a counselor went back to get my graduate degree and have been a counselor now for 30 years. With trauma as by specialty to help other people. Know the symptoms that create the victim thinking from PTSD, so you don’t get trapped by them or so you can become aware to make a different choice, once you are aware and know there is help These are the Clinical symptoms out of our DSM Diagnostic manual to diagnosis PTSD.  There are 5 sections, I will go over to see if you have some of these sx. If so, treatment is critical not to keep, making unhealthy thought habits going to cement this victim life style in place, because you don’t know what to do or never even know you have the sx of PTSD. You must have the first criteria and if you don’t, there is not PTSD diagnosis.  I hear from clients that think they must have PTSD because they were bullied, and in fear.  Or the opposite, sexually abused but, I was never penetrated, so it can’t be abuse or have PTSD sx.  Not necessarily true for both examples, or they could be true for both, it is the reaction to the event and how it has affected the person with symptoms. 1st criteria: You must have actually been exposed directly to a trauma that threatened death or serious injury or sexual violence. For more than one month, the client has been experiencing symptoms of re-experiencing: 4 other section you must have At least 1 symptom: 1.Presence of Intrusion symptoms associated with the traumatic distressing memories of the traumatic events such as: Distressing dreams, Flash backs. Psychological distress, or a Physiological response to internal or external cues that resemble the trauma. 2. One of these: Avoidance of the distressing memories, thoughts or feelings associated with the trauma  or Persistent avoidance of people, places, and things that reminds them of an associated memories or traumatic events. 3. 2 or more of these: Negative alterations in cognitions and mood associated with traumatic events; Inability to remember an important aspect of the traumatic event, Negative beliefs about self or the world because of the traumatic event.  Persistent, distorted beliefs about the cause of the trauma.  Marked diminished interest in significant activities, feeling of detachment or estrangement from others, Persistent inability to experience positive emotions. 4. 2 of these: Reactivity or arousal associated with the trauma that is evidenced by: Irritable mood, reckless destructive behaviors, Hyper-vigilance, exaggerated started response, problems with concentration and Sleep disturbance. It can also have dissociative symptoms if feeling detached from reality or feeling of the world is unreal to you This is the mental and physical anguish that the clients suffer, which can be traced back to a traumatic event. While PTSD affects both adults and children, the percentage among war veterans is significantly skewed. While PTSD is be found at a rate of about 9% in the general population, it shoots to as high as 30% among deployed and non-deployed war veterans. PTSD symptoms can be psychological and behavioral. A patient may go through their trauma repeatedly in their nightmares and thoughts. Alternatively, they may completely avoid situations that remind them of the trauma or stay constantly over-vigilant. Such symptoms lead to sleep deprivation and sudden loss of temper. Needless to say, a condition like PTSD has a negative impact on the quality of personal relationships with lack of trust in other and worst within yourself and performance at work with inability to communicate, socialize because of frustration and anger, irritability,  that can be  unintentionally targeted towards the partner, family or co-workers. Situations that would otherwise be non-consequential become big issues. It can lead to spats at work and even escalate to domestic violence. The key is to identify the symptoms early, get help, and create a system of support to help. I have found, from my specialty with trauma my 30 years as a mental health profession, you can learn to manage this, not cure this.  I consider this a brain injury from the trauma that you thought you were going to die and you brain has now been wired differently, to protect you in all ways. But the good news is, if you wired this, you can rewire it. Now because of the pandemic, we need to be aware of a new traumatic stress called Secondary Traumatic Stress when the stress overwhelms the coping mechanism leaving people feeling out of control and helpless.  Continual exposure to the trauma, like health care or Mental Health workers or caregivers become depleted, exhausted, or worse self-destructive.  We are already seeing in with depression rates increasing and suicide rates increasing with caregivers.  With many of the same sx as PTSD.  And only 40% of the clients seek treatment.  This treatable. The best treatment is Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT)you can find Apps for and download to teach you skills to work with your symptoms.  This is treatable. DBT has 3 components and has been shown to have the highest success rates. Because it has a workbook with it.  That you can open up in the moment of the app to open up in the moment and look at ways to deals with an emotion or the freeze up response in the moment, if you go the restroom and use it. There is also mindfulness component to learn how to let go and not get so attached and agitated by situations, or people.  And it includes the CBT or looking at the thoughts that you are having in that moment that is either helping or making the situation worse. You can learn to Stop think breath and make a new choice in the moment to make the situation worse. There is exceptionally good treatment, and it HAS to be within your Control when with who to do treatment.  Because avoidance and lack of trust are huge issues, and you must feel you choose your treatment. But please choose it to learn to Trust Yourself most of all, please reach out if you want it or need it. You can find an 1800 on the back of your insurance card for the Mental health service that your insurance will pay for.  There is help through you work look in the HR manual for EAP for 6 free sessions.  Or ask a friend who helped them with these issues.  Many Veteran agency have specific groups and training to build skills to feel better. I certify clients to have an ESA and I have found that one ways as one of the simplest most helpful, if you can have your dog with you in more places or to go to a family gathering, if you have you dog friend with you Our website for that is ESAPros.com You can learn to trust yourself again. Please reach out. Or go to our website anxietysimplified.net for other resources. Happy New Year’s Welcome 2021 Join the Conversation Our favorite part of recording is answering your questions, from Facebook at AnxietySimplified5.  Leave comments in the comment section, we will answer on a Podcast on that subject.  So, listen for your question.  Or share it with someone who may be helped with that answer.  Our next podcast: Success Creating Achievable Goals. See other podcasts at AnxietySimplified.net

My outsides look coolMy insides are blueFIRST VERSE:It's Pride Month, and in celebration of all things LGBTQIA+, Marko and Tony are taking a break from their weekly #GayRelationshipGoals (it'll be back July 2nd, don't worry) to bring a month of #GayHistory. This week, the guys dive into the pathology and history of homosexuality and all the rights (or lack thereof) that came with the judging of one's sexuality. The guys break down the DSM (Diagnostic and Statistical Manual)'s understanding of homosexuality and how gay and lesbian people were viewed as a whole. To make sense of where we're going, we need to better understand where we came from - and Marko and Tony try their best to make that happen, this week. Tune in to learn more! HAPPY PRIDE MONTH!CHORUS:“But if you can't look inside youFind out who am I tooBe in the position to make me feel soDamn unpretty”Self-esteem and self confidence are not easy to come by. In a world that puts so much value on looks, salary, family life, relationships, and all other things surface and (often times) empty - how does one learn to love themselves? And, once you accomplish self-love and take a full dive into the abyss that is gay culture, where does one draw a healthy amount of self-esteem from? This week, the Critellis chat about their relationship with self-esteem, and pass along some tips and tricks to make sure you feel good about yourself.SECOND VERSE:Psychology Today: https://www.psychologytoday.com/us/basics/self-esteem Psych Central: https://psychcentral.com/lib/how-to-raise-your-self-esteem/Tom Bruett Therapy: https://tombruetttherapy.com/improve-your-self-esteem-as-a-gay-man/Reach Out . com: https://au.reachout.com/articles/10-tips-for-improving-your-self-esteem BRIDGE:Marko and Tony are beyond excited to be joined by queer, heterosexual couple: Molly and Sean Gazay-O'Connor, this week. After meeting through podcast guests and mutual friends, Maria and Owen, the guys snag Molly (@mollygazay) and Sean and learn more about their relationship beginnings, cuddle puddles, how they'd define their relationship, and how they manage to stay together. This is a great interview with such fascinating people! Join us for all the fun - you'll be glad you did.http://www.mollygazay.com - - - - - TUNE IN:Tune in to Relationsh@, for a behind the scenes post-show conversation about this week's episode! Visit Instagram (@podrelationshit) every week for more Relationshit content! - - - - - SHOP: Go to supergayunderwear.com, and don’t forget to use promo code CRITELLI at check out for a 10% discount on your super gay purchase of underwear, clothing, and accessories! - - - - - EMAIL US:relationshitquestions@gmail.comEvery month, Marko and Tony will devote an episode to your relationship questions and concerns. Write in if you need some guidance or direction.Support the show (http://www.patreon.com/podrelationshit)

What is schizophrenia? It is a psychotic disorder that typically results in hallucinations and delusions, leaving a person with impeded daily functioning. The word schizophrenia translates roughly as the "splitting of the mind," and comes from the Greek roots schizein ( "to split") and phren- ( "mind"). The onset of the disease typically occurs in young adulthood; for males, around 21 years of age, for females, around 25 years of age. We don’t know exactly what causes schizophrenia. There are certain predictors for it, and as I discussed the basics and pharmacology a previous podcast, frequent marijuana use can increase the risk of a psychotic or schizophrenic illness to about 4 times what it would be without THC use. History of schizophrenia Sometimes, in ancient literature, it can be difficult to distinguish between the different psychotic disorders, but as far as we know, the oldest available description of an illness resembling schizophrenia is thought to have existed in in the Ebers papyrus from Egypt, around 1550 BC. Throughout history, in groups with religious beliefs, the misunderstanding of the psychopathologies caused people to paint those with mental health disorders as receiving divine punishments. This theme of divine punishment continues today in some parts of the world. It wasn’t until Emil Kraeplin, a german psychiatrist (1856-1926) that schizophrenia was suggested to be more biological and genetic in origin. In around 1887, Kraeplin differentiated what we call schizophrenia today from other forms of psychosis. At that time he described schizophrenia as dementia of early life. In 1911, Eugen Bleuler introduced schizophrenia as a word in a lecture at a psychiatric conference in Berlin (Kuhn, 2004). Bleuler also identified the positive and negative symptoms of schizophrenia which we use today. Kurt Schneider, a german psychiatrist, coined the difference between endogenous depression and reactive depression. He also improved the diagnosis of schizophrenia by creating a list of psychotic symptoms typical in schizophrenia that were termed “first rank symptoms.” His list was: Auditory hallucinations Thought insertion Thought broadcasting Thought withdrawal Passivity experiences Primary delusions Delusional perception (the belief that a normative perception has a certain significance) Sigmund Freud furthered the research, believing that psychiatric illnesses may result from unconscious conflicts originating in childhood. His work eventually affected how the psychiatric world and society generally viewed the disease. The history and lack of understanding of the disease is a dark history, and it is still deeply stigmatized, but psychiatry has made massive leaps in understanding schizophrenia and changing how it is viewed in modern society. Nazi germany, the United States, and other Scandinavian countries (Allen, 1997) used to sterilize individuals with schizophrenia. In the Action T4 program in Nazi Germany, there was involuntary euthanasia of the mentally unwell, including people with schizophrenia. The euthanasia started in 1939, and officially discontinued in 1941 but didn’t actual stop until military defeat of Nazi Germany in 1945 (Lifton, 1988). Dr. Karl Brandt and the chancellery chief Philipp Bouhler expanded the authority for doctors so they could grant anyone considered incurable a mercy killing. In reading about this event, it seems that This caused approximately 200,000 deaths. In the 1970’s, psychiatrists Robins and Guze introduced new criteria for deciding on the validity of a diagnostic category (Kendell, 2003). By the 1980’s, so much was understood about the disease that the DSM (Diagnostic and Statistical Manual of Mental Disorders) was revised. Now, schizophrenia is ranked by World Health Organization as one of the top 10 illnesses contributing to global burden of disease (Murray, 1996). Unfortunately, it is still largely stigmatized, leading to an increased schizophrenia in the homeless population, some estimates showing up to 20% vs the less than 1% incidence in the US average population. In conclusion On the podcast episode, we discuss the media’s portrayal of schizophrenia. Although media paints mentally ill as often violent, on average people with mental illness only cause 5% of violent episodes. This is just one example of how the stigma is furthered. The more we understand about this disorder—what causes it, how we can help, how we can provide therapy and medicate and treat patients—the better. Getting rid of the stigma by learning the history and also moving beyond preconceived ideas to the newest science will also help de-isolate people with schizophrenia and help support them in communities, giving them a chance at a normal, healthy life. Link to full episode: notes Link to sign up for CME go: here Member Login to do CME activity go: here Instagram: dr.davidpuder Twitter: @DavidPuder Facebook: DrDavidPuder

In this episode of the podcast Larry Quicksall talks about the DSM (Diagnostic and Statistical Manual of Mental Disorders) including its history, use in making consistent diagnosis, and how it is used in treatment. --- Support this podcast: https://anchor.fm/ihateanxiety/support

In this episode of the podcast Larry Quicksall talks about the DSM (Diagnostic and Statistical Manual of Mental Disorders) including its history, use in making consistent diagnosis, and how it is used in treatment.

Nervous Habits host Ricky Rosen and sister & Clinical Psychology doctoral candidate Holly Rosen do a deep (and intensely personal) dive into mental health disorders and their prevalence in America today.  Ricky and Holly address a number of topics in the fields of psychology and neuroscience including: --Why more than half of all mental illness in America today goes undiagnosed and untreated... --The root cause behind the over-diagnosis of ADHD in children... --Why modern-day psychology tends to confuse personality traits and psychopathological disorders... --Whether medication or therapy is the more effective method to manage mental illness, and finally... --How living with anxiety disorders might actually enhance your life.   Where to Go to Get More Information: 1. Mental Health by the Numbers (National Alliance on Mental Illness) https://www.nami.org/learn-more/mental-health-by-the-numbers 2. DSM (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) https://www.psychiatry.org/psychiatrists/practice/dsm 3. Anxiety Disorders (National Institute of Mental Health) https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml 4. "OCD" - Neil Hilborn https://www.youtube.com/watch?v=vnKZ4pdSU-s

There is a saying in the Autism community: "If you've seen 1 person with Autism, you've seen 1 person with Autism." There are so many manifestations that really don't fit in the categories defined by the DSM (Diagnostic and Statistical Manual) used by psychologists and psychiatrists. Amanda Baggs, an adult with Autism, posted a video on Youtube in 2007, has over 1 million views and accurately describes what she calls the 'workings of the Autistic brain." It will shift your thinking about how a person with Autism thinks. Check it out here: https://youtu.be/JnylM1hI2jc

Was ist Psychotherapie? Michael Buchholz findet das gar nicht so leicht zu definieren. Ziemlich sicher ist, dass es darum geht, miteinander zu sprechen und dadurch psychische Probleme zu behandeln. Die Psychoanalyse wird daher auch als "Redekur" bezeichnet. Doch was unterscheidet verschiedene Formen von Psychotherapie – und wann gelingt eine psychotherapeutische Behandlung? Im Gespräch erwähnte Literatur: Buchholz, Michael (2017). Zur Lage der professionellen Psychotherapie. Forum der Psychoanalyse, 33, S. 289–310. Buchholz, Michael (1999). Psychotherapie als Profession. Psychosozial-Verlag. Woofolk, Robert L. (2015). Vom gesellschaftlichen und kulturellen Wert der Psychotherapie. CIP-Medien. Personen: Winnicott, Donald W. (1896–1971): Englischer Kinderarzt und Psychoanalytiker, vor allem bekannt für seine psychoanalytische Arbeit mit Kindern Luborsky, Lester (1920–2009): Psychoanalytiker und Psychotherapieforscher, bekannt für empirische Psychotherapieforschung Wampold, Bruce (*1948): Emeritierter Professor für Beratungspsychologie, University of Wisconsin Insel, Thomas R. (*1951): Neurowissenschaftler, Psychiater und ehemaliger Leiter des NIMH Beck, Aaron T. (*1921): Psychiater, Psychotherapeut, unter anderem Entwickler des Beck-Depressions-Inventar (BDI) und Wegbereiter der Kognitiven Verhaltenstherapie Abkürzungen: DSM – Diagnostic and Statistical Manual NIMH – National Institute of Mental Health NICE – National Institute for Health and Care Excellence

Psychopathy is not a Mental Illness, as some people may think. It's actually a Personality Disorder. In this episode of Green Healing, I explain what a Mental Illness is, what a Personality Disorder is, and I talk more about Psychopathy, referring to the DSM (Diagnostic and Statistical Manual) and the APA (American Psychological Association), as well as the PCL-R (Psychopathy Check List).Learn more about Psychopaths as a Type of Abuser: https://youtu.be/KK2wddLvQT4Find Green Healing on iTunes: https://itunes.apple.com/ca/podcast/green-healing/id1347790311Support Green HealingPayPal Tip Jar: http://www.binkyproductions.com/howtocontributePatreon: https://www.patreon.com/BinkyProdBitcoin: 362g1NRU5TnKLS3a674oHcDXBNeCUGriqohttps://binkyproductions.com/greenhealinghttps://binkyproductions.com/healingthroughhumourTwitter: @binkyprodhttps://steemit.com/@binkyprod

In this throwback episode, Dee talks to Reesh & Srav River about the evolution of the DSM (Diagnostic and Statistical Manual of Mental disorders) and the inherent challenges of Psychiatry in Modern Medicine. ** This episode contains original production by the homie Ray Diaz aka Basik559 (with permission from the Artist): soundcloud.com/ray-diaz-2 Leave us a Voice Message on Anchor, Hit us up on Social Media & Consider leaving us a review in Podcastville to let us know what you think about us :) Facebook: facebook.com/MedicineRemixed Instagram: instagram.com/medicine_remixed Twitter: twitter.com/medicineremixed Anchor: anchor.fm/medicineremixed --- Send in a voice message: https://anchor.fm/medicineremixed/message

Jill and David encourage Mark to develop his list of positives. Mark draws a blank at first. This is very common among patients and therapists alike. Most of us have not been trained to think about depression, anxiety, shame, defectiveness, hopelessness and anger as being good or positive. In fact, we think of them as symptoms of “mental disorders,” according to the DSM (Diagnostic and Statistical Manual of the American Psychiatric Association.) So we think of them as bad, something to get rid of, something needing treatment. But after David and Jill prime the pump, Mark is surprised that they quickly come up with a list of 16 positives that are real and powerful. At this point, they ask Mark why in the world he’d want to press the Magic Button and have all of his symptoms suddenly disappear--given all these positives. This is called the Acid Test and it's also paradoxical. David and Jill have now become the resistant part of Mark's subconscious mind--the part that clings to these symptoms. And when the therapists become the voice of the resistance, the patient will nearly always become the voice that argues for change. The paradox is resolved with the Magic Dial. Toward the end of this podcast, you will want to review Mark’s Daily Mood Log, with the Goal column filled out on the table of negative emotions. David points out that there is no single tool or technique that triggers recovery in patients. Instead, each component of T E A M contributes in radically different ways to the substantial or even dramatic improvement the therapists are hoping to bring about it today's session. In the next Podcast, David and Jill will begin the M = Methods portion of the session.

The widely held belief that the diagnosis of mental disorder is a matter exclusively for value-free science has been much reinforced by recent dramatic advances in the neurosciences. In this lecture, I will use a detailed case study of delusion and spiritual experience to indicate to the contrary that values come into the diagnosis of mental disorders directly through the language of the diagnostic criteria adopted in such scientifically–grounded classifications as the American Psychiatric Association’s DSM (Diagnostic and Statistical Manual). Various competing interpretations of the importance of values in psychiatric diagnosis will be considered. Interpreted through the lens of the Oxford tradition of linguistic-analytic philosophy, however, diagnostic values in psychiatry are seen to reflect the complex and often conflicting values of real people. This latter interpretation has the direct consequence that there is a need for processes of assessment in psychiatry that are equally values-based as evidence-based. A failure to recognise this in the past has resulted in some of the worst abusive misuses of psychiatric diagnostic concepts. In the final part of the presentation I will outline recent developments in values-based practice in mental health including some of its applications to diagnostic assessment, and in other areas of health care (such as surgery). (February 3, 2016)

The widely held belief that the diagnosis of mental disorder is a matter exclusively for value-free science has been much reinforced by recent dramatic advances in the neurosciences. In this lecture, I will use a detailed case study of delusion and spiritual experience to indicate to the contrary that values come into the diagnosis of mental disorders directly through the language of the diagnostic criteria adopted in such scientifically–grounded classifications as the American Psychiatric Association’s DSM (Diagnostic and Statistical Manual). Various competing interpretations of the importance of values in psychiatric diagnosis will be considered. Interpreted through the lens of the Oxford tradition of linguistic-analytic philosophy, however, diagnostic values in psychiatry are seen to reflect the complex and often conflicting values of real people. This latter interpretation has the direct consequence that there is a need for processes of assessment in psychiatry that are equally values-based as evidence-based. A failure to recognise this in the past has resulted in some of the worst abusive misuses of psychiatric diagnostic concepts. In the final part of the presentation I will outline recent developments in values-based practice in mental health including some of its applications to diagnostic assessment, and in other areas of health care (such as surgery). (February 3, 2016)

8 AM - Psychotherapist Gary Greenberg, author of "The Book of Woe: The DSM and the Unmaking of Psychiatry," talks about the new version of the DSM (Diagnostic and Statistical Manual of Mental Disorders); Castro brothers were interviewed.