For psychiatrists who practice dance therapy: dealing with falls

[novopsych]

This is a post for fellow psychiatrists who practice dance therapy. I’m guessing there aren’t any on here, but if I post this it will become indexed by search engines and other psychiatrists who employ dance therapy might find this and chime in.

What do you do when a patient falls down during the dance? Do you yourself continue dancing and pretend not to notice? Do you help the patient up? Do you ask them how they feel about falling down? A few of my elderly clients have fallen over the last 6 months during interpretive dance. During one-on-one dancing, it’s very unlikely for them to have a fall as obviously two people brace each other. But during these three episodes of falling, I decided it was best to let the clients have their dignity and I continued dancing off in the corner with my back to them as they righted themselves.

In two cases, I turned back around when I could tell the clients were on their feet, and I ignored the fact that they weren’t dancing. In those instances, they picked up on my cue that nothing had happened and started dancing again, which I think was probably very therapeutic. However, those two started speaking and mentioned something about their falls after they started dancing again, and I just told them I hadn’t noticed anything and to keep dancing. (Speaking is discouraged during the dance.)

The third patient, however, would not right herself. I peeked and saw her fussing on the floor, and I danced out of my office to have my secretary check on her. I’m sure this will be obvious to other dance therapists, but for those who aren’t, it’s a very tricky boundary issue to address a patient in a non-dance way when you are in the middle of the dance, which is why I had to send in the secretary. If you don’t get it, think of it as any other form of frame deviation during psychotherapy.

An ambulance was called while I continued my interpretive dance in the waiting room as to not acknowledge the patient’s non-dancing behavior. As she was carried out, I continued dancing and was careful not to look in her direction. After she had been removed, I danced back into my office and continued dancing until our appointment was scheduled to end in order to maintain the frame.

That patient turned out to have a hip fracture, which was ascribed by another doctor, who was not present during the appointment, to the fall. I maintain that this particular patient suffers from somatoform disorder she refuses to acknowledge, which greatly increased her experience of pain. I unfortunately can no longer work with her as our work was always exclusively through the dance, not talk therapy. To address what happened now through talking would be to completely leave the frame, and so I had to release her.

But it just occurred to me that a temporary fall, as with the other two patients, could be a teachable moment. I just hate to leave the flow of the dance, though. I really try to attract a vibrant clientele and sometimes when you give in too much, you make a person weaker rather than stronger. If I pay attention to the fall, am I then just encouraging them to 1) leave the dance and 2) languish in self pity?

Also, does anyone have any suggestions on minimizing falls in the elderly? I find that interpretive dance is one of the best treatments for elderly depressives, but it’s also turning out to have a higher side effect profile than I anticipated. I can’t in good conscience promote adaptive interpretive dance (that’s a whole other conversation), but I am open to other dances that could help.

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[Indodo]

Finally someone gets it!
Interpretive dance is probably the single best treatment for elderly depressives! Folk and Macarena are very close second. I have found the Polka to be excellent adjunctive therapy even though the main use is obviously appendicitis.
BTW, I heard the mosh pit to be very good for MERS. Prancing is essentially a cure for cancer. Dancing school will most likely replace medical school in the next 5-10 years. Who needs medications or surgery when you have the Foxtrot?

 

[jakeislove]

Finally someone gets it!
Interpretive dance is probably the single best treatment for elderly depressives! Folk and Macarena are very close second. I have found the Polka to be excellent adjunctive therapy even though the main use is obviously appendicitis.
BTW, I heard the mosh pit to be very good for MERS. Prancing is essentially a cure for cancer. Dancing school will most likely replace medical school in the next 5-10 years. Who needs medications or surgery when you have the Foxtrot?

That actually made me cry laughing.

Thanks! I was stressing and feel much better and happier.

 

[Armadillos]

The third patient, however, would not right herself. I peeked and saw her fussing on the floor, and I danced out of my office to have my secretary check on her. I’m sure this will be obvious to other dance therapists, but for those who aren’t, it’s a very tricky boundary issue to address a patient in a non-dance way when you are in the middle of the dance, which is why I had to send in the secretary. If you don’t get it, think of it as any other form of frame deviation during psychotherapy.

An ambulance was called while I continued my interpretive dance in the waiting room as to not acknowledge the patient’s non-dancing behavior. As she was carried out, I continued dancing and was careful not to look in her direction. After she had been removed, I danced back into my office and continued dancing until our appointment was scheduled to end in order to maintain the frame.

That patient turned out to have a hip fracture,

 

[erg923]

My wife made me (us) take dance lesson before our wedding. I found my lack of rhythm demoralizing. Not only that, but coming to thr realization that I actually have two left feet made me damn near suicidal.

 

[slappy]

:troll:

 

[Ceke2002]

Not a trained dance therapist, not a health practitioner of any description, but I do incorporate aspects of dance therapy and body movement into my own personal treatment plan (I'm a patient currently under the care of a Psychotherapy orientated Psychiatrist). The dance is not something I do with my Doctor, but he knows about it, and encourages it. I use dance and movement for the induction of trance states, and also as a way to connect with my body which tends to be separated from my mind owing to a long term eating disorder - so lots of improvised movement, letting go of ego and 'self' and allowing my body to just move at a subconscious 'free' level. I'm sure you know what I'm talking about, and I do understand in the context of dance or movement therapy and the practice/teaching there of that the dance is meant to be organic. Just as you wouldn't tell a patient how to feel or speak in conventional talk therapy, you don't tell then how to dance or move in dance therapy sessions. My understanding is that the patient takes the lead in emotional expression through their body and it is up to you to mirror that expression through your own movement, so a communicative link is established beyond words in order to tap into the deeper subconscious levels of the mind. It's also my understanding that to break the frame during a dance therapy session, ie to stop dancing, is somewhat akin to a boundary violation in traditional therapy. But don't forget you can have boundary crossings, crossings that are ultimately beneficial to the patient, without it becoming a boundary violation. I also understand the need to keep dancing even when the patient isn't, because you are retaining their emotional state through movement in order to better empathise with or mirror back to them how they're feeling; however I do think there are limits and ways to handle a situation where a patient falls, or is seriously injured. The patient who broke her hip, rather than dancing off in a corner somewhere, why didn't you mirror her movements on the ground, make eye contact, open your expression to her to let her know of your concern* (dance is expressive, the face is part of the body as well, you can use it to convey emotions and questions without words). Bear this in mind as well - there is still dance in stillness, holding poses, holding emotions, "holding" your patient in the moment...you don't need to be dancing in movement to do that.

Edited to add - * And immediately rendered proper medical care and assistance when the situation had become clear.

 

[AGSIII]

I've found pole dancing has the best outcome.

 

[Ceke2002]

I've found pole dancing has the best outcome.

 

[MacDonaldTriad]

I think it would be really great to know how to dance well. I would do anything to be able to cut a rug and actually enjoy looking good at it. Anything except of course enduring the horror and humiliation of having to practice my way through the complete idiot I am now when it comes to dancing. Of course being an over the hill married white guy does mean that the number of opportunities when I have to dance is almost down to a comfortable zero. Unlike skiing, swimming, or learning how to ride a bike, dancing has a particular shame to it while you are trying to get started.
Once I thought it might be easy to become a flamenco dancer. How hard could it be to stomp your feet while holding an expression of pained anorgasmia on your face? Then I saw some bad flamenco, believe me, good flamenco dancing is beautiful, but there is nothing worse than bad flamenco.

 

[jakeislove]

Dance has been helping people feel better for years!

 

[wolfvgang22]

I've never heard of dance therapy as a real thing a psychiatrist might do. I've always lumped it into the category of "hippy new age meditation type stuff that may qualify as excercise." The way OP describes it sounds a lot like it's part of a psychodynamic therapy.

Is there any evidence for dance therapy? I'm genuinely curious but not curious enough to search Pubmed yet.
What is the fee structure for dance therapy? What are the treatment goals?
I know that exercise and increased socialization is helpful for a number of things.

I imagine the laughter that would result from watching me dance would be somewhat therapeutic.

 

[OldPsychDoc]

I've found pole dancing has the best outcome.

Perhaps Vistaril has done some research in this area.

 

[Sporadicus]

This was written with such eager sincerity that I really cannot tell if it is a joke or not.

 

[erg923]

Yea, it always advisable to not communicate with your patients when they are in physical or emotional distress and to act like a dancing robot who doesn't deviate from "a frame." I am sure this is what Freud had in mind....

 

[jakeislove]

Yea, it always advisable to not communicate with your patients when they are in physical or emotional distress and to act like a dancing robot who doesn't deviate from "a frame." I am sure this is what Freud had in mind....

.... what if recovering from the fall, and dancing again, is their healing moment and the doctor's communication aborts it?

 

[erg923]

Present an explantory model, backed up with outcome studies and I'll be happy to continue that convo.

If you try to use the ole "corrective emotional experience" argument, I will also ask you to present data, just FYI...

 

[erg923]

Dance has been helping people feel better for years!

Say it with me..."I'm a psychiatrist and I'm proud!"

 

[novopsych]

I've never heard of dance therapy as a real thing a psychiatrist might do. I've always lumped it into the category of "hippy new age meditation type stuff that may qualify as excercise." The way OP describes it sounds a lot like it's part of a psychodynamic therapy.

Is there any evidence for dance therapy? I'm genuinely curious but not curious enough to search Pubmed yet.
What is the fee structure for dance therapy? What are the treatment goals?
I know that exercise and increased socialization is helpful for a number of things.

I imagine the laughter that would result from watching me dance would be somewhat therapeutic.

Definitely good evidence. Here's a place to start: http://www.adta.org

I don't take insurance. However, my pay scale for dance therapy sessions is more in line with what other psychotherapists charge. Medication is handled, when needed, in separate sessions.

This was written with such eager sincerity that I really cannot tell if it is a joke or not.

Yes, I've heard all the jokes about the "dancing psychiatrist." My undergrad degree is in the dance. I am a psychiatrist who dances, not a dancing psychiatrist. Big difference.

 

[Leo Aquarius]

For my depressed outpatients, I start every session with 20 minutes of break dancing.

For the autistic, we do the moon walk.

For the borderlines, especially the ones with pink hair, I make them do 20 minutes of pole dancing. They just love spinning round and round.

And for the narcissists, I take em outside and make them do 5 miles of Parkour. The ones that come back alive get to continue therapy in my air-conditioned office.

 

[hamstergang]

This was written with such eager sincerity that I really cannot tell if it is a joke or not.

If the OP is serious, then what is described is seriously unethical and constitutes malpractice. So I'm going to give OP the benefit of the doubt and assume it was just a joke.

 

[wolfvgang22]

If the OP is serious, then what is described is seriously unethical and constitutes malpractice. So I'm going to give OP the benefit of the doubt and assume it was just a joke.

I don't see how augmenting more traditional, evidence based psychiatric practice with group dance therapy would be either unethical or malpractice, if that is what OP is doing, and seems like it is what OP is doing.

Obviously, the OP didn't know that the patient had broken a hip initially, and probably felt terrible when she found out the patient was indeed injured.
The OP noticed the patient with known somatization history had fallen down, and immediately got some help without abandoning other patients in the midst of a therapy session. What would you have done instead?

The only way to guarantee no injuries in dance is to not dance.
I'm going back down to my foam lined nuclear bomb shelter for a nap now.

 

[hamstergang]

I don't see how augmenting more traditional, evidence based psychiatric practice with group dance therapy would be either unethical or malpractice

If you ignore an elderly patient when they fall and squirm on the floor, then I say you're unethical. Dancing your way to the receptionist wastes time in getting an ambulance. Plus, the doctor in the room should be responsible for evaluating the patient -- does she need an ambulance for a possible fracture, MI, or stroke, or is this just a case for advil and an ice pack? Is the patient having a seizure? Not assessing this is surely malpractice. Imagine if she died of an MI and the lawyer asks OP why he/she didn't get and use an AED.

 

[Armadillos]

From novopsych's previous posts and this thread its very clear that patients were never the priority, "the dance" is the priority.

 

[Sporadicus]

If the OP is serious, then what is described is seriously unethical and constitutes malpractice. So I'm going to give OP the benefit of the doubt and assume it was just a joke.

I agree; I don't think any board-certified physician, even one with an undergraduate degree in "the dance," would be so incompetent as to author a post that details gross negligence on her part in lieu of the likely malpractice suit she just exposed her office to.

 

[erg923]

Definitely good evidence. Here's a place to start: http://www.adta.org

Are we using the same definitions of "science," "data," "evidence," and "psychiatry?!"

If this is serious, i agree with others. How dumb do you have to be to describe gross medical negligence (not to mention psychiatric malpractice) on a public forum. Hope you haver a lawyer on retainer, dude. Grandmas and veterans, man. Grandmas and veterans....

 

[xlithiumx]

Seriously Novopsych. Don't. Just don't. I can't even.

 

[jakeislove]

Say it with me..."I'm a psychiatrist and I'm proud!"

LOFL!!

 

[Leo Aquarius]

With all this talk about dancing, what do you tell the patient in the wheelchair?

 

[michaelrack]

 

[vistaril]

Perhaps Vistaril has done some research in this area.

well I'll put it this way- I've never left any of my favorite gentlemans clubs over the years(pink pony, cheetah, tattletale lounge) in a bad mood.....that counts for something.

 

[Leo Aquarius]

Hahahaha... nice one Dr. Rack.

 

[Ceke2002]

If you ignore an elderly patient when they fall and squirm on the floor, then I say you're unethical. Dancing your way to the receptionist wastes time in getting an ambulance. Plus, the doctor in the room should be responsible for evaluating the patient -- does she need an ambulance for a possible fracture, MI, or stroke, or is this just a case for advil and an ice pack? Is the patient having a seizure? Not assessing this is surely malpractice. Imagine if she died of an MI and the lawyer asks OP why he/she didn't get and use an AED.

Yeah, gonna have to agree with this. I'm supportive of dance therapy, as I indicated in my previous post, and I do incorporate dance into my own treatment plan. If OP is so determined to maintain the frame of dance in a session then I did try and give some suggestions as to how she could immediately check on her fallen patient whilst still doing so, but to me therapeutic dance frame or not there are times when it's more important to haul arse out of there and get help, like immediately, and then return to take care of your patient until help arrives. Put it this way, when I suddenly doubled over in extreme pain during a session with my Psych he didn't exactly just sit there and keep talking to me to maintain the therapeutic 'frame'. The session was stopped immediately to assess and ascertain if I was okay (I was, some of my muscles had just gone into spasm and knocked the wind out of me), and for a few minutes after I'd recovered he kept a pretty close eye on me, whilst insisting I just rest for a moment, before he was satisfied that the session could then continue. I get what the OP is saying, and I get why she continues to dance during a session when most people would be thinking 'er, shouldn't you have like stopped or something?', but my opinion as a lay person, if you're continuing to dance at a distance from a patient who's lying on the ground with a broken hip, then you're more invested in your own needs and experience than that of the patient.

Edited to add: And I've just read the code of ethics on that page, and unless my interpretation of the wording is wrong, choosing to continue dancing whilst a patient requires medical assistance is a breach of the code of ethics according to the ADTA.

 

[Ceke2002]

I've never heard of dance therapy as a real thing a psychiatrist might do. I've always lumped it into the category of "hippy new age meditation type stuff that may qualify as excercise." The way OP describes it sounds a lot like it's part of a psychodynamic therapy.

Is there any evidence for dance therapy? I'm genuinely curious but not curious enough to search Pubmed yet.
What is the fee structure for dance therapy? What are the treatment goals?
I know that exercise and increased socialization is helpful for a number of things.

I imagine the laughter that would result from watching me dance would be somewhat therapeutic.

Bear in mind I'm coming at this from the point of view of a patient who isn't engaged in any sort of official dance therapy, but I do use dance as an augmentation for traditional talk therapy and medication when indicated. I don't really consider that my treatment begins and ends at the start and finish of every therapy session with my Psych, so I do do a lot of stuff on my own at home as an adjunct - including, in no specific order, ritual prayer/invocations (I've mentioned before I'm a practitioner of Wicca), mindfulness and other forms of meditative practice, yoga, energy work with chakras, and dance. When I speak of using 'dance' in the context of more traditional treatment augmentation as well, I'm not talking about just getting up and having a bit of a jive around the lounge room. I use dance and movement as a form of active meditation, and to sometimes also induce a trance state.

Things I have personally found this (ie dance) useful for, and those I haven't (again just to reiterate this is in conjunction with traditional talk therapy)

Mild to Moderate Depression - Excellent, especially when combined with more traditional meditation practices and yoga.

Severe Depression - Dancing at the end of a rope maybe (sorry gallows humour - pun not intended). If I can barely get out of bed and function on a daily basis, all the 'ease on down the road' in the world aint gonna be getting me stabilised any time soon. Bring on the clinically indicated medication and concentrate on talk/psychotherapy.

Anxiety - Excellent for ongoing prevention, but if I'm in the middle of a panic attack it doesn't work so well and can often times make the attack worse.

Emotional Disregulation - Bit complicated this one. With unstable emotional disregulation if it's practiced on an ongoing basis it can form the frame work to help reduce the instability and as a way to actively 'relearn' healthier coping/regulation techniques. But once you've reached the point where you're in complete emotional free fall and you've basically ended up having a screaming fit whilst needing to be restrained for your own safety (thankfully my husband is trained in certain safe restraint techniques) then yeah, dance not gonna help. Once you've reached a more stable level though, then it becomes more of a maintenance type thing, as well as now on the rare occasions when I do start to emotionally disregulate more often than not I can catch myself before things progress beyond a certain point, and meditative dance can then take the place of emotional expression in the moment. If that makes any sense.

Psychotic Symptoms/Hallucinations/Etc - Excellent as a distraction tool, but this is the one time when I do just 'dance' without incorporating the meditative and/or trance inducing aspects. Yeah it's great if I'm, say for example, hearing voices I can just stick on some music, get up dance and ignore them/distract myself until they go away or stop or whatever. But putting myself into a meditative or trance state when I'm experiencing psychotic symptoms, that can be a bit of a dangerous slippery slope into increasing rather than decreasing symptoms. I mean the way I see it, if I'm hallucinating I'm already in a sort of semi altered state of consciousness as it is, so why would I then decide to take myself into that any further.

Now excuse me while I get up and dance

 

[erg923]

It should be quite obvious that any social activity that includes (presumably enjoyable) physical excercise of some type would likely improve some symptoms of depression. Its called behaviroal activation. Its the B in CBT. We have known this for many, many years. It is not a monotherapy, generally, and it should not used in a manner that makes the practitioner appear like a weird cult member, however (not talking to patients, dancing to ambulances and other such nonsense). That, and the obvious medical negligence shown here is what is concerning to me. When all you have is hammer everthing looks like a nail, etc. "The dance" isn't the patient here. The patient is the patient. You take care of him/her at all costs, not "the dance."

 

[Ceke2002]

It should be quite obvious that any social activity that includes (presumably enjoyable) physical excercise of some type would likely improve some symptoms of depression. Its called behaviroal activation. Its the B in CBT. We have known this for many, many years. It is not a monotherapy, generally, and it should not used in a manner that makes the practitioner appear like a weird cult member, however (not talking to patients and dancing to ambulances and other such nonsense). That, and the obvious negligence shown is what is concerning to me. When all you have is hammer everthing looks like a nail, etc.

Agreed. If you're continuing to dance when a patient is in dire need of medical assistance, and can't even acknowledge the patient's distress and need to send in a (presumably) non medically trained receptionist to deal with the problem so you can maintain the dance, then to me that smacks far more of the therapist engaging in the 'therapeutic frame' for their own needs/experience to the exclusion of everything else including their patient - it's more important to dance than it is to actually provide care for the individual in need, or should I say the therapists 'need' to dance is more important than providing care for the individual in need.

I had a similar situation with a previous Psychologist I saw some years back, before I started working with my current Psych. Every thing, every symptom and session was based solely around the idea of Patriachal oppression and the subjugation of women by men as being the sole causal aspect in all women's psychopathology. You could have walked into a session and said you were feeling stressed because the bus was running late, and you almost missed the appointment, and she still would have found some way to work in a tirade against men and the patriarchal system. All I heard from her was 'the Patriarchy, oppression, men, grrr'. I lasted three appointments with her and on the third appointment it became clear that she wasn't interested in actually treating me she just wanted to lecture and push her own agenda to the exclusion of all other considerations. She was throwing magazines in my lap, practically yelling at me to 'see the truth, see what men have done, this is why you are suffering as a woman', and I just looked at her and thought 'Wow you are so far off base it's not even funny'. It was all about her, what she wanted to see, her vision, her interpretation, etc etc, the patient's individual experiences and input be damned.

 

[vistaril]

Present an explantory model, backed up with outcome studies and I'll be happy to continue that convo.

If you try to use the ole "corrective emotional experience" argument, I will also ask you to present data, just FYI...

I think dance therapy for older depressed patients sounds like a great idea. Can't be any worse than what we have now, and it probably carries less risk. But I would differ in the OP that I just go see if a patient was hurt by a fall immediately and call ambulance if neccessary. Of course thats the exact same thing a social worker who is doing dance therapy should also do...

 

[vistaril]

appointment it became clear that she wasn't interested in actually treating me she just wanted to lecture and push her own agenda to the exclusion of all other considerations. She was throwing magazines in my lap, practically yelling at me to 'see the truth, see what men have done, this is why you are suffering as a woman

lmao...if I was working with her I would walk in one day and tell her to go fix me a cup of coffee....2 creams.

 

[Still Kickin]

This is a post for fellow psychiatrists who practice dance therapy. I’m guessing there aren’t any on here, but if I post this it will become indexed by search engines and other psychiatrists who employ dance therapy might find this and chime in...

...Also, does anyone have any suggestions on minimizing falls in the elderly? I find that interpretive dance is one of the best treatments for elderly depressives, but it’s also turning out to have a higher side effect profile than I anticipated. I can’t in good conscience promote adaptive interpretive dance (that’s a whole other conversation), but I am open to other dances that could help.

Wondering what exactly "adaptive interpretive dance" is, I fired up the ole Google-Machine. As far as search engine indexing - mission accomplished - one of the first few links led right back here...

That actually made me cry laughing.

The patient who broke her hip, rather than dancing off in a corner somewhere, why didn't you mirror her movements on the ground, make eye contact, open your expression to her to let her know of your concern*
* And immediately renderedpropermedical care and assistance when the situation had become clear.

Obviously, the OP didn't know that the patient had broken a hip initially, and probably felt terrible when she found out the patient was indeed injured.

..I get what the OP is saying, and I get why she continues to dance during a session...

I haven't been around in awhile, is the OP known to be female? (Just curious - in my head I was reading this as having been posted by a male. I'd elaborate on why I thought that but I don't want to appear to be male-bashing...)

After she had been removed, I danced back into my office and continued dancing until our appointment was scheduled to end in order to maintain the frame.

This was written with such eager sincerity that I really cannot tell if it is a joke or not.

 

[jakeislove]

 

[wolfvgang22]

I said "she" just because in my limited experience, people interested in dance have been mostly female. It's just a stereotype from my own bias. Good job pointing that out, Still Kickin. OP could be male for all I know.

I agree that if I see a patient fall, I'm going directly to his or her side to render assistance.
I would just caution clinicians against playing armchair quarterback and accusing another psychiatrist of malpractice immediately without knowing all the facts, or ignoring some facts. We don't even really know the first thing about OP, whether OP is male or female! I certainly wasn't there, if this really happened, and neither were you, and we aren't some investigatory board.
Keep in mind that just because this is an informal forum doesn't mean some lawyer wouldn't try to use posts against a doctor in court.
I wouldn't want that done to me, would you?

On a related but separate note: I feel there is a lot of irrational hate toward OP and dance therapy. Maybe that isn't the intent by each individual poster, but that's how it comes across overall when I read these threads. It makes us look like a lynch mob, in my humble opinion. If I was OP, I'd probably never post here again. I agree that there may not be much evidence for dance therapy, but that doesn't mean it's good, or that it's bad, or that it should be made fun of in a mean way. Maybe I'm too thin skinned? I've made it clear in a previous post that my initial bias is that dance therapy for mental illness is hippy/new age nonsense, but I'm open to being wrong.

Anyway, I'd love to see more research done on dance therapy and if it's mostly benign and even a little beneficial to patients, I'm cool with it.

 

[erg923]

It makes us look like a lynch mob, in my humble opinion. If I was OP, I'd probably never post here again.

IMHO, the posters post makes us look like idiots in the eyes of the public (this is public forum). I will happily lynch persons who do this.

 

[smalltownpsych]

Why do so many practitioners not understand that just because something is therapeutic does not mean that they should turn it into art therapy, horse therapy, dance therapy, primal scream therapy, pet therapy, aromatherapy and then bill it as a cure for anything? For me skiing is an extremely therapeutic endeavor and I have had some great conversations on ski lifts. Great idea! Ski therapy!

 

[Sporadicus]

Why do so many practitioners not understand that just because something is therapeutic does not mean that they should turn it into art therapy, horse therapy, dance therapy, primal scream therapy, pet therapy, aromatherapy and then bill it as a cure for anything? For me skiing is an extremely therapeutic endeavor and I have had some great conversations on ski lifts. Great idea! Ski therapy!

You just answered your own question smalltown...

 

[smalltownpsych]

You just answered your own question smalltown...

Hope you recognize that I was being sarcastic. Of course, I guess you were too!

 

[hamstergang]

I would just caution clinicians against playing armchair quarterback and accusing another psychiatrist of malpractice immediately without knowing all the facts, or ignoring some facts. We don't even really know the first thing about OP, whether OP is male or female! I certainly wasn't there, if this really happened, and neither were you, and we aren't some investigatory board.
Keep in mind that just because this is an informal forum doesn't mean some lawyer wouldn't try to use posts against a doctor in court.
I wouldn't want that done to me, would you?

I wouldn't want that done to me, which is why I would never do something as unethical as described in the OP, and even if I did I wouldn't post about it proudly online. And I feel most agree with me. Which is why I'm still assuming OP is not real.

 

[wolfvgang22]

Why do so many practitioners not understand that just because something is therapeutic does not mean that they should turn it into art therapy, horse therapy, dance therapy, primal scream therapy, pet therapy, aromatherapy and then bill it as a cure for anything? For me skiing is an extremely therapeutic endeavor and I have had some great conversations on ski lifts. Great idea! Ski therapy!

If Ski Therapy isn't harmful, and is actually helpful, why not offer it to patients and bill for it? Just because you don't want to doesn't mean no one should.
Who made you, or me, the judge of what is and is not therapy?

 

[erg923]

If Ski Therapy isn't harmful, and is actually helpful, why not offer it to patients and bill for it? Just because you don't want to doesn't mean no one should.
Who made you, or me, the judge of what is and is not therapy?

One has a moral, ethical, and legal obligation to provide services that are based on what research literature supports as most effective and efficient. That's what being a "mental health professional" means. Its what differentiates you from my grandma (grandmas are always therapeutic). Or having coffee with a "life coach." People who are not mental health professionals have no such obligations, and thus can use whatever maybe therapeutic as a first line treatment. We do not have that luxury.

 

[CrileDO]

The OP seems like something Dr. Curtis Jay from "Broom of the System" might do.

 

[Armadillos]

One has a moral, ethical, and legal obligation to provide services that are based on what research literature supports as most effective and efficient.

I'm not entirely sure this is true, especially your contention that there is a "legal obligation" to only provide the most "efficient" services. There are plenty of things we do in medicine that aren't efficient by any means, but are in no way illegal.

That being said, I completely agree with you that the OP actions are outrageous and I think she is abusing the physician label to basically beef up her dance instructor credentials .