Presentation at the PPA Annual Convention 2011 Molly Cowan has since earned her doctoral degree.

1. Personal Safety and Self Care Molly Cowan MA Simone Gorko MS Donald McAleer Psy.D., ABPP PPA Convention 2010

6. Dr. Calmncool is in solo private practice. Her office suite is in a small building whose other tenants are mostly sales personnel, usually in and out throughout the day and gone by 5PM. Dr. Calmncool is conducting an initial interview with Mr. Narse who is employed in a mid-sized company as a department manager with a small staff he supervises. Because of his work schedule, he requested an evening appointment. The presenting complaint is that he feels undervalued by his superiors, as well as his staff. He believes they disrespect him because he isn’t “higher on the management totem pole” in a position of power. He also complains that his wife doesn’t appreciate him or even try to understand how he feels or what he is going through. Mr. Narse states his treatment objectives as “wanting to learn how to swagger with bravado and command respect and admiration from others.” Dr. Calmncool validates his distress and discomfort, but acknowledges she does not do the kind of work he is requesting. She reframes the situation as one where they could examine his behaviors, attitudes and expectations and how he might be able to build more confidence and positive interpersonal relationships, thereby achieving his goals. Mr. Narse becomes increasingly agitated, asserting that Dr. Calmncool is “just like the others,” his superiors, staff and wife. He indicates she doesn’t understand and is unwilling to help him. He begins to berate her, demanding to know what kind of psychologist she is that she won’t help him in the way that he want, the objectives he wants. Dr. Calmncool maintains her demeanor, tries to defuse the situation and do some psycho education about what therapy and psychology are and are not. Mr. Narse lurches forward into her personal space, stares her in the eyes and bellows at her, “You don’t love me!” What should Dr. Calmncool do? What are the issues of self care here?

9. Frequency of Professional Stressful Events in the Last Twelve Months Never Once Twice Three or More Been stalked by a patient 94% 5% <1% <1% Been robbed by a patient 97% 2.3% <1% <1% Been assaulted by a patient 97% 2% 1% 1% Threatened with assault 88% 8% 3% 2% Had patients assault third party 82% 9% 4% 5% Had patients threaten to assault third party 78% 11% 4% 5% Had patient commit suicide 86% 10% 2% 2% Had patients attempt suicide 68% 16% 8% 8% Had patient make suicidal gesture 46% 17% 15% 23% Had patient threaten suicide 46% 18% 12% 25% Been sexually harassed by a patient 94% 3% 2% 1% Knapp and Keller, 2004

11. Guy, Brown and Poelstra, 1992

18. How does the Ethics Code help to guide us?

28. Guy, Brown and Poelstra, 1992

33. Questions Discussion